Still holding back seeing doctors with Medigap Plan G?

[Rianne]

I have Plan G so only the deductible to pay. I don't have any hesitancy about seeing a doctor, specialist or otherwise when I need to. That said, I don't have high medical needs yet so don't really see anyone that often.

Last year I had I needed to have a biopsy after a mammogram. The radiologist at the place that did the routine mammogram kept talking about how the location was difficult and he might or might not be able to do it through ultrasound.

Anyway, I decided to drive about 5 hours to go to MD Anderson. I knew that they do this kind of thing a lot. I used to live close to them and many years ago had had a biopsy there (no cancer).

So, I simply called them on the phone and explained what I needed. They told me what records they needed. I made the trip and everything went well. (The radiologist there had no hesitancy about doing the biopsy and thought it strange the other doctor had been hesitant).

Total cost was a small amount left on my annual Medicare deductible. I would do it again. One reason I like traditional Medicare is that I have no networks.

Thanks. MD Anderson is an excellent medical system, especially for breast cancer. It's good to know you went there with no issues.

 

[rk911]

haven't read all of the replys so pardon if mine is redundant. the OP has traditional medicare with a medicare supplement plan G. this allows the OP to see ANY doctor anywhere the USA flag flies as long as that doctor accepts traditional medicare. we have run into one doctor that only accepted Medicare Part C (Medicare Advantage) plans. we have supplement Plan F and are very happy with traditional Medicare and the Plan F supplement.

 

[lawman]

AFAIK you could. As for coverage, every doctors appointment I've ever made asks about insurance/Medicare, and I would think the doctor would warn you if your coverage might not cover as much as you might be expecting. Doctors don't want angry patients or bad reviews (these days).

Why wouldn't you proactively ask the provider anyway? If you get an unexpected charge and you didn't ask any questions up front, whose fault is that? Nothing wrong with asking here first, but I'd sure double check with the provider myself.

That's what I thought until I got on Medicare..Every time I have asked the Dr. about cost they tell me they have no idea about coverage. It all comes down to coding and some providers have people coding that are not competent, especially when it comes to bloodwork.

 

[tednvon]

Hello, I was Medical Social Worker for many years so dealt with Medicare a bunch. Also have been on Part F Supplement for 12 years. G and F are almost identical except for the initial deductible which just about zeros out when you compare your slightly lower monthly Premium. It is GREAT Coverage. You can see most any MD, PA, PT, Nurse Practitioner coast to coast with no deductible or copay. IMO, you cannot have better coverage for inpatient and outpatient care. You will need to decide if you want to get a Part D Drug Plan for prescription medications. Good luck

 

[meleana]

I always had high deductible health plan before retirement. I rarely used the health insurance partly because I am quite healthy. Now that I am retired with a Medigap plan G for 2 years now, somehow my mindset hasn't changed from that old habit.

I understand that, you are free to see any specialists without concerns of much cost incurred as long as small deductible is paid. So, do you actually start booking appointments with specialists with minor ailments? Are there any restrictions or limitations of what you can/should do?

My husband and I go where we need to or want to go. No issues. In fact, right now I’m seeing an orthopedic doc about surgery and I just made an appt with a neuro doc at a different hospital for a second opinion.

I went to PT for 12 weeks. I’ve had an in office biopsy and another procedure in the hospital. Had my colonoscopy a few weeks ago. Our regular doctor visits. Eye doctor. Blood work. Radiology testing. Had to go to the ER two weeks ago. Etc etc. The only thing we’ve paid is the Plan G deductible.

This said, we don’t go to specialists for minor things. We go to our primary doc or urgent care if necessary.

We are not people who always like to go to doctors, but unfortunately in our late 60’s things started to happen and it’s necessary.

I guess we’re in the breakdown lane.��

 

[isisdave]

With Plan N you also have $20 co-pays on top of the $233 annual deductible. So if you intend to have lots of office visits, Plan G may be more cost effective.

Do the math, though. For me, N was about $50 less per month, or $600 per year, than G. That's thirty $20 co-pays. There's a $50 copay for ER visits unless admitted to hospital, also, but not urgent care. The price will vary with your age and location.

And the $20 applies to "office visits" but not to most procedures. So when you visit the dermatologist and she freezes stuff on your body, it does apply. But if you have to come back for more extensive work, it usually doesn't. Medicare is complicated to the point of mystery.

I have never seen an "excess charge" which is something people worry about with Plan N. About seven states prohibit them anyway.

 

[euro]

Yes, I plan to ask lots of questions. I just remember my MIL was DX with colon cancer within a year after going on Medigap. She had several chemo treatments, and surgeries, over 7 or 8 years. DH said she paid nothing. That seems so unbelievable to me.

They may have had Plan F (no longer available though) and if they did, they would have not have any co-payments or deductibles for any of the hospitals or doctors visits. They WOULD have paid monthly premiums though plus any drug co-pays.

 

[euro]

Do the math, though. For me, N was about $50 less per month, or $600 per year, than G. That's thirty $20 co-pays. There's a $50 copay for ER visits unless admitted to hospital, also, but not urgent care. The price will vary with your age and location.

And the $20 applies to "office visits" but not to most procedures. So when you visit the dermatologist and she freezes stuff on your body, it does apply. But if you have to come back for more extensive work, it usually doesn't. Medicare is complicated to the point of mystery.

I have never seen an "excess charge" which is something people worry about with Plan N. About seven states prohibit them anyway.

I tend to agree that for most people Plan N is probably slightly more cost effective than Plan G. However, I try to keep things as simple as possible, especially looking into the future, so I prefer not having to deal with the co-pays at each visit. I do suspect though that this type of thinking will probably lead to slightly faster premium increases for G over time since those who are sicker and therefore tend to use more medical services are more likely to join Plan G policies. Ultimately, I have convinced myself that the difference between G and N will NOT be an existential problem for DW and I, so we will prefer the more simple option.

 

[Lvus101]

Found these videos to be very helpful

 

[PatrickA5]

Found these videos to be very helpful

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