An odd question - need help....

[tcb]

I have a friend who's over 65 and is on Medicare plan A&B with no additional personal coverage.

He hasn't been to the doctor's in YEARS -- he gave me the book to see if I could find out if regular doctor's office visits are covered (ie: general ailments, prescription renewals)

I can't figure the darn book out --- so I'm hoping someone here will know the answer....I'm in Canada - if you're sick you go to the Dr - if you need an operation - you get one -- this Plan A & B thing is like Greek to me

[tcb]

(bump)

Can anyone help??

[eraylsteel]

TCB Moerator;
I will try somewhat to help.
I and my wife are also in that age bracket.
Medicare does not pay for prescriptions.
The individual has to pay the FIRST- ONEHUNDRED DALLARS of doctors visits.
Then the individual pays 10 Dallars per visit.

From there Medicare pays 80 Percent of APPROVED Charges.

Hospital care falls into the same catagory.
80 Percent of APPROVED Charges.

Some Doctors accept what Medicare pays.
Others want the whole bill paid so you have to shop around for a Doctor on that one.

We have a Supplamental Insurance that pays what Medicare does not pay, except we pay a copay of 5 Dallars for Generic Medicine or 10 Dallars for Brand Name Medicine.

Our Health Care Insurance is - United Health Care
The same company I had during my working career.
It is a very good company and they pay what they say they will.
They also encourage you to have checkups for wellness visits.
Your only cost is 10 Dallars per visit.
Visits to specialists is 0

I put the word APPROVED in capitol letters because that is the trick word.
When it comes to Hospital care and treatment the APPROVED comes in way under what the actual Charges are.
Hope this helps

[eraylsteel]

I'll try posting again.
Medacare does NOT pay for Prescriptions.
Patient pays 10 for doctor visits
There is a 100 dlr up front deductible for doctor or Hospital care - just one deductible

Then Medicare pays 80 percent of APPROVED charges
the key word is the word APPROVED
That means they don't pay all the health care costs and
they don't neccassarly APPROVE all charges.
That is why us old folks need a supplimental insurance To cover what Medacare doesn't .

[eraylsteel]

Thats odd now the other post is on here

[tcb]

Thanks eray -- that helps out tremendously!! Prescriptions and Dr's visits are what he's worried about most -- I'll pass on the information to him!

Thanks so much!!!