This doctor is an absolute fool who knows nothing of the plight of the retiree.
Everything Medicare from around the web.
This doctor is an absolute fool who knows nothing of the plight of the retiree.
Wow, so glad I viewed this, it makes sense for people that are in good
health and taking generic low cost drugs. Thanks for taking the time to
post this information.
No problem. Also, be sure to check out this link for more current and
comprehensive information on what Medicare really covers:
http://truecostofhealthcare.net/medicare-supplemental-insurance/
Thank you for making something that counters what we see from the insurance
industry. Seniors are targets for all kinds of predation in this culture.
David, you completely disregarded the fact that Plan F and High Deductible
Plan F covers “excess charges” as well— doctors can charge up to 15%
higher than Medicare Assignment. Also, the fact that the 20% co-insurance
has no limit is reason enough for any rational human with assets to AT
LEAST get a high-deductible Plan F to protect themselves in the case of
catastrophic outpatient costs. Not even mentioning extra days in the
hospital, extra benefits for skillled nursing, blood transfusions, and
more. Overall, this video is misleading and dangerous in my opinion. The
insurance is SUPPOSED to be profitable to the company— on average you are
SUPPOSED to utilize it less than what you pay. that is the concept of
insurance— you pay to protect you in the case you need it.
Dr. Belk is just exposing this highway robbery of the insurance companies,
the facts he is relaying are available on various sites. The agents that
are bellowing out here take a good part of that monthly premium, that’s why
they are demonizing an honest doctor.
Let’s play with some numbers. Let’s say I am a Medicare patient (A/B), and
I need a not-uncommon coronary-artery bypass surgery. Let’s say total
hospital and surgical charges are a total of $100K (a realistic albeit
outrageously inflated amount). Now, according to this, from debt.org: “…
total payments are often broken down into hospital expenses (60-80%
depending upon procedure), physician payments (13-19%), and post-acute care
(7-27%).” So, worst case for this scenario, the hospital bill is $80K.
Regardless, my only out-of-pocket is the $1,288 annual deductible. Worst
case for this scenario, the charges of the surgeon(s) and other medical
personnel = (rounding up) $20K. Medicare can easily discount that to $5K,
and then pays 80%. I co-pay $1K.
My $100K surgery has cost me $2,288. (I haven’t included out-of-hospital,
post-operative care, but Medicare does pay for the first 20 days in a SNF.)
Is this a figure that frightens you? What happens if you don’t pay it? A
few calls from collectors. Want to be “honorable,” but keep a little in
your pocket? Make an offer. The providers have already been paid a lot and
made a profit, even at Medicare’s rates. They’ll take your offer.
I realize I’ve addressed only one kind of event here. If someone has a
chronic disease with continuous large bills, maybe a supplement is worth
it. If someone thinks my numbers or the scenario are whack, then I’d like
to hear it. Otherwise, I believe Dr. Belk is right-on and on the right
side!
One last thing, if you’re not 100% behind a federal Medicare-for-all
program, you’re an ignoramus.
Well, quite pleased to have your response, doctor. Even more pleased to
have confirmation of my (educated) guesstimate. I don’t recommend
“stiffing” the hospital, but I’ve learned (at least with one of our local
hospitals) that, given some persistent resistance, it will discount 40% off
the private-insurance allowable. And they have a policy of not suing. It’s
all a racket. I was SO hoping that Sanders would be prez, and move the ball
forward on M-for-all. Thanks much for what you do. I look forward to
reviewing more of your videos and links.
Yeah, $2,000-$2,500 is the approximate out of pocket cost for a Medicare
patient who undergoes coronary artery bypass surgery. That will cover most
of the outpatient follow up as well. I wouldn’t recommend stiffing the
hospital, though. They will go after you and they’re usually not very nice
about it.
your patients are not telling you the truth then because there is no $400
premium anywhere in California. I don’t mean to be disrespectful with you
but you are really misinformed, I am licensed in 24 states and there is no
state with those type of premiums unless the person is on Medicare
disability under the age of 65.
1. The rates have gone up since 2012.
2. The rates for smokers as well as for those who are under 65 and received
Medicare did exceed $400 a month in 2012:
http://truecostofhealthcare.net/wp-content/uploads/2015/05/Supplemental-Premiums-2.pdf
3. Even $347 a month for non smokers over 85 is way too much for what these
policies really offer.
This man is dangerous to listen to. I see supplements in all 50 states and
nowhere are supplements $400 a month. Yes it’s true that Medicare pays 60
days of hospitalization, but only after a deductible of $1260. This only
covers inpatient care, not your physician services which is covered under
Part B at 80%. Do you want to pay 20% of a surgery? He is also very
mistaken about Part D. It is true that generic medications are cheap, but
what if you are a diabetic and have to take insulin? Filling one vial of
insulin can be between $400 to $600 a month. Not everyone needs
supplemental insurance, or even Part D, but saying that nobody does, and
using vastly inflated premiums for examples is just as bad as someone who
wants to scare you into buying something you don’t need.
+gaspar17 400 for a vial of insulin? That is NOT true. Go to Walmart where
you don’t even need a prescription for a vial of insulin at about $20.
+Anne Craig Not in any state I have ever been in. Insulin is one of the
most expensive medications out there. Don’t think you would ever benefit
from a Medicare Supplement and just want to do straight Medicare? Try
getting RA and having to do shots of Reclast and pay the 20% of that $5000
per shot medication. This is just one example of the benefits of a Medicare
Supplement. There are many more.
+gaspar17 I’ve seen a medigap cost $500 on more than 1 occasion.
+Concerned Agent Then your using the wrong companies and not doing your
clients a service. Try the Plan G prices and compare to the Plan F. I will
bet the price difference more than makes up the Part B deductible. I just
did a Plan G for an 82 y/o female in Nevada for $164. This guy is seriously
mistaken.
+Jason Casey You are right on the money Jason…………….Tucson Agent
Don Ketcham
Disagree
I have no idea who to listen to because I have no more faith in doctors
than I do the insurance companies. Health care is not about treating the
patient but what they can bill insurance companies for.
I have cancelled two medical appointments in the past week, which is scary
because I have glaucoma and diabetes. I am insulin-dependent and destined
to stay that way because I was diagnosed as a Type-1 long after I thought
that I was too old. I even argued with the doctors at the hospital where I
was diagnosed that surely I was Type 2. Yet I had also thought that I was
safe because I wasn’t overweight before I got diabetes, so what do I know?
I mean I was 20 minutes away from the intensive care unit with
keytoacidosis (spelling?) from high blood sugar before I even knew that I
was diabetic. Yet I have lost count of how many times the paramedics have
woke me up by putting sugar into me with an IV needle because I was found
unconscious and non-responsive.
The fear that I have because I never know how much the doctor’s
receptionist is going to demand that I pay immediately, even though I was
not given fair warning that I was going to owe this, has me cancelling
doctors’ appointments in order to make sure that I will not have to hand
over money earmarked for groceries like I did last time because the doctor
wouldn’t see me for if I didn’t pay much more than I was expecting before I
got there. Oh, well, I hate having to eat anyway and have begged doctors
for years to get me some nutritious insulin because food is the enemy for
we diabetics so maybe saving me that trip to the supermarket wasn’t really
so bad on her part.
My Medicare is original Medicare and just started in July. My Medicare
premium is about a third of my total disability amount from Social Security
before I was terminated while on medical leave from Disney World after I
failed the physical needed to keep my job. The whole thing is so
discouraging that the insulin that I need in order to live is a threat to
my life. So far all of my dangerously low blood sugars have been accidental
because I am what is called a “brittle diabetic” so that I can swing too
low and too high within a couple of hours. Sometimes I wish that I had the
courage to just take a whole bottle of insulin at once and just end this,
but I am afraid that doing that would be committing the one unforgivable
sin. Sometimes I think that I am already in hell, so what is the
difference?
Apparently the Medicare supplement that I thought might be my rescue from
the stress of the unknown could just make things worse. I am grateful to
get your perspective on this though so I do thank you for telling the truth
as you see it. I think that many doctors are afraid to say anything
negative about insurance companies which they may very well consider to be
a rip off.
By the way, do you think that maybe I might someday get my wish to be able
to get all of the calories and nutrients that I need without having to eat?
That would be really great because I am sick of the assumption that
illnesses suffered by diabetics are self-imposed. Food is just medicine so
I wouldn’t miss it.
+Mary Simas, if your income is as low as you say, you may be able to
qualify for Extra Help with your prescription coverage. You can do that by
contacting your local Social Security Office or call 1-800-772-1213. Here’s
a link which explains how it works:
https://www.ssa.gov/pubs/EN-05-10508.pdf
If you qualify for 100% Extra Help you will pay no more than $7.40 for your
insulin.
Buying a Medicare Supplement is not going to help you with your
prescriptions, since Med Supps do not include prescription coverage.
You also said that your fear is not knowing how much the doctor’s office
will demand that you pay before your visit. In this case I suggest that you
contact Medicare and ask them which Medicare Advantage plans are offered in
your area. Some areas may offer plans with as little as $0 monthly premiums
and $0 to $10 copays for your primary doctor. If he or she is a part of
that network, they cannot charge you more than your copay.
Good luck to you. Try not to stress too much, stress is a killer.
An F plan supplement (the industry standard) pays 100% of the part A
deductible ($1100) and 100% of the 20% of part B the senior is responsible
for. There is no co pays or out of pocket costs after the premiums are
paid. They do not cost 200 -400 in most cases. I just wrote one 3 hours ago
on an 83 year old lady. The premium is $169.00 month. (rates go by state
and zip code for different carriers) It also pays the $147 part B
deductible. It is correct that Medicare must cover the procedure. Medicare
will process and approve an “assigned” amount. Once that is established,
the supplement will pay the remaining 20%. There are specialists that are
“non assignment” doctors. They reserve the right to bill up to but no more
than 15% over the assigned amount. So the Medicare recipient is responsible
for 35% in that case, all of which would be paid for. I have been in
Medicare insurance for 20 years. I have seen claims paid very small and I
have seen a client have his 20% be $80,000. You can always roll the dice
and say the odds are…….What are the chances of you having a fire in
your home? Very slim. Does that mean we cancel the fire insurance? That’s
the point. Most seniors that have and can afford a supplement, would not
part with it out of fear. Fear is the ONLY reason you buy ANY type of
insurance. Insurance is to ‘transfer risk” in case something does
happen…….and it does to some people. With all due respect to this
doctor. He needs to focus on medicine because sales and salesmanship is not
his bag. Also I would ask him what are the chances of him being sued for
mal practice? I don’t know either, but I bet he has some malpractice
insurance.
Nice. Just show generic drugs. Not taking part D also means that you have
to wait until January. Advising someone to go without is not responsible.
You…..
+Rick Erickson And do not forget if someone does not get a drug plan then
they will get a penalty added on when they need it and do get it down the
road. So then that individual will pay MORE then the average person because
they did not have it.
Thank you for your candid report and trying to help us.
This is the most absurd video that I have ever heard, considering that you
have no clue about the cost of supplements, you just overstated the cost by
300%, and on a large surgery unless you are going to eat the 20% that
Medicare does not pay then the customer will have to pay thousands of
dollars. I can go over and over the poison that you are feeding the poor
people that listen to you!
I’m also licensed in 24 states and like yourself, I make a good living, but
unlike yourself, I’m not extremely proud of the industry I’m in. You’re
using the same scare tactics the majority of agents use–omg, if you have a
major surgery in a hospital, they will bill you hundreds of thousands and
you will be responsible for 20%. Not true, they will be responsible for
$1288. I suggest you educate yourself and check out what Medicare allowable
rates are for different areas and procedures, you would be amazed. It’s not
going to help you sell more insurance, but at least you’ll know the truth.
There are some instances where I would strongly recommend getting a
supplement, for someone who’s in end stage renal disease, for example. If
they need dialysis three times a week at $40 per treatment, that translates
into $6240. By all means, get a supplement when you can, it would save you
a lot of money. Someone who’s relatively healthy is better off putting that
$2,000-2,500 yearly premium in a savings account in case they might need a
major surgery later in life.
I have patients who tell me they pay that much for their supplemental
premiums.
you stated $400 per month with is not true at all
Here are Medicare Supplemental premium rates for Blue Shield of California
for non smokers from 2012 (they’ve gone up since then):
http://truecostofhealthcare.net/wp-content/uploads/2015/05/Medicare-Supplemental-Premiums.pdf
As you can see, Plan F rates start at about $133 a month for a 65 year old
but then rise rapidly to over $200 a month for for a 71 year old. So the
rates they give 65 year olds are basically teaser rates. All other claims I
made in the video are backed up by bills, EOBs and links to Medicare itself
on this webpage here:
http://truecostofhealthcare.net/medicare-supplemental-insurance/
I think Medicare supplements are very good Health Insurance v Medicare
Advantage Plan.
Price Advair, Lantus, xarelto, cymbalta, Revlimed for cancer….you are
saying don’t get coverage? Revlimed does not wait for January. You are
dangerous!
This guy is an idiot…
False information. Seniors if you drop your coverage, supplement or pdp,
sue this guy for misleading you.
+Jessie Vasquez That would be a fascinating lawsuit. I would actually enjoy
that.
Your facts and numbers on copays are very misleading and could really hurt
someone who follows your advise.
If you’re going to post a comment without allowing a reply, it will be
removed.
+Don Ketcham “Dr.” Ketcham, let me understand what you’re saying. Your
patient owes you $100,000 for a surgery, and because Medicare is slow to
pay and difficult to deal with, you’re billing this amount to a
supplemental plan directly and expect to get $100,000 the next day? If this
is your understanding on how supplemental insurance works, then I doubt
you’re even an insurance agent.
+Don Ketcham I looked you up. You sell insurance in Tucsan AZ, unless this
is some other guy:
https://www.linkedin.com/profile/view?id=ADEAAA7vQEsBPzVZZwIv7xOQbFF_fuBykxsC4ag&authType=NAME_SEARCH&authToken=6zG6&locale=en_US&srchid=3666645061442005389543&srchindex=9&srchtotal=10&trk=vsrp_people_res_name&trkInfo=VSRPsearchId%3A3666645061442005389543%2CVSRPtargetId%3A250560587%2CVSRPcmpt%3Aprimary%2CVSRPnm%3Atrue%2CauthType%3ANAME_SEARCH
I am a patient advocate. This will not affect my bottom line but it will
affect my patient who owes me $100,000.00 for the surgery I performed
because they did not have a supplement plan. You for some reason cannot
process what insurance is all about. What do you pay car insurance for???
What benefit do you get from paying car insurance??? Your analogies to
gas and oil are stupid. YOU HAVE CAR INSURANCE IN CASE OF A CATASTROPHIC
EVENT.
What ax do you have to grind? As a Physician I am wondering about your
mental state. Why would you be so adamant about spreading your horribly
wrong opinion on supplements to Medicare? I have a vested interest as I
want to get paid by my patients or their insurance. Medicare is slow pay,
difficult to deal with, bloated government program that is a detriment to
my practice. What dog do you have in this hunt?
Your an idiot. Part C is giving insurance companies money-just in different
ways. So sorry we cannot all be rich like you and self fund after Medicare
doesn’t pay, but I have seen more people benefit under supplements than
anything else.
+Jason Casey If medicare doesnt pay then the supplement doesnt pay.