obviously I do not understand the difference between Medicare and a medi- gap policy. My mother used to pay for a medical insurance policy monthly that was her "primary insurance" and Medicare was secondary. All of her Drs and hospital bills and labs were covered and she only had to pay a portion of her drug bills. The first company became too expensive so she switched to a different company that was taken over by her current company. Mom has large co-pays for any dr who is not her GP.
A doctor told me that I should switch mom over to Medicare as primary, that a lot of Doctors do not like the private company that she has. This Doctor stopped taking the company that my mom has because they paid so little and that Medicare paid better.
I met a stranger yesterday outside of the doctors office and she told me that she had Medicare as primary and Medicaid as secondary and that she does not pay any co-pays and nothing when she is in the hospital. Mom does not qualify for Medicaid but is there another way that I can get a policy that would pay what Medicare does not pay? Is that what a "gap policy" is? Mom does have Medicare part D for drugs and her drug bill is around $150 a month until late fall when she will reach her limit then things will be nearly free.
Please can someone explain the differences to me that I am not understanding. I googled it but found that confusing too. Thanks!
Medicare generally reduces the amount billed to an amount specified for various services, then pays 80% of that. BCBSM picks up the 20%, so of the amount allocated for covered services, 100% is paid. That gap between the 100% approved by Medicare less the 80% paid by Medicare is the "gap".
Other than long term care over a decade ago, my father has had no bills to pay of his own other than dental, for which we have a different type of coverage but it doesn't pay as much as Medicare would if Medicare covered dental (which it doesn't).
For me, the only thing I've had to pay has been the cost of a tetanus shot, which I decided to get because of gardening and using so many different kinds of tools, some of which are sharp and could cause accidental cuts. I haven't yet injured myself from the tools, but just want to be on the safe side.
This is a fairly basic explanation of the Medicare Plans A, B, C, and D (medication plan). www.medicareinteractive.org/page2.php?topic=counselor&page=script&script_id=214
Many people purchase the Part D insurance for their prescription drugs. My father's prescription drugs are so minimal that it would be more expensive to purchase the insurance than just pay out of pocket. I take no prescription drugs so it's not an issue for me.
Hope this helps.