| [GMCnet] Welcome to Obama Care [message #284299] |
Sat, 08 August 2015 15:25  |
glwgmc
Messages: 1014
Registered: June 2004
Karma: 10
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Senior Member |
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That sounds like one of the Medicare Advantage Programs whereby you contract with the Medicare Advantage provider who normally has far better coverage than Medicare itself. They bill Medicare a negotiated monthly amount equal to the average health care cost for their insurred group. Such programs normally attract a healthier client base so the insurer can provide better coverage at the same cost. At least that is how they work in the west. Sharon and I are on the Advisory Board for one owned by the docs in the region. It has been very successful and now runs a whole variety of State programs as well as the Medicare Advantage program. Such things as the Medicade for low income, Public Employee Union programs, etc.
In our system we provide patient advocates to help you through the labarinth of hospital and dr. billing. A check mark haphazardly placed in the wrong box on a form can dramatically increase or decrease the billed cost. Our tax code also allows hospitals and docs to over bill and write off the difference between what they bill and what they actually get paid by whomever. Only some one who works this beat all the time can find such stuff for you. Get one on your side and your life will get better immediatly.
Jerry
Jerry & Sharon Work
Kerby, OR
glwork@mac.com
http://jerrywork.com
78 Royale with most everything done to modernize a GMC mechanically
77/94 Clasco bone stock and looks like it just left the Clasco facility
Both drive equally as well.
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Message: 10
Date: Sat, 08 Aug 2015 10:42:12 -0600
From: Emery Stora
To: "gmclist@list.gmcnet.org"
Subject: Re: [GMCnet] Welcome to Obama Care
Message-ID:
Content-Type: text/plain; charset=us-ascii
The problem is that I technically am not covered by Medicare. The plan I have with Humana is a Medicare plan where I assign all Medicare payments to Humana and Medicare doesn't pay any claims directly to providers.
I'll have to wait and see what happens with billings to me from the hospital.
Emery Stora
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Jerry & Sharon Work
78 Royale
Kerby, OR
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| Re: [GMCnet] Welcome to Obama Care [message #284304 is a reply to message #284299] |
Sat, 08 August 2015 15:59  |
emerystora
Messages: 4442
Registered: January 2004
Karma: 13
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Senior Member |
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Yes, it is a Medicare Advantage program.
I'll wait until I hear more and then decide if I need an advocate.
Thank you all for the advice.
Emery Stora
> On Aug 8, 2015, at 2:25 PM, Gerald Work wrote:
>
> That sounds like one of the Medicare Advantage Programs whereby you contract with the Medicare Advantage provider who normally has far better coverage than Medicare itself. They bill Medicare a negotiated monthly amount equal to the average health care cost for their insurred group. Such programs normally attract a healthier client base so the insurer can provide better coverage at the same cost. At least that is how they work in the west. Sharon and I are on the Advisory Board for one owned by the docs in the region. It has been very successful and now runs a whole variety of State programs as well as the Medicare Advantage program. Such things as the Medicade for low income, Public Employee Union programs, etc.
>
> In our system we provide patient advocates to help you through the labarinth of hospital and dr. billing. A check mark haphazardly placed in the wrong box on a form can dramatically increase or decrease the billed cost. Our tax code also allows hospitals and docs to over bill and write off the difference between what they bill and what they actually get paid by whomever. Only some one who works this beat all the time can find such stuff for you. Get one on your side and your life will get better immediatly.
>
> Jerry
> Jerry & Sharon Work
> Kerby, OR
> glwork@mac.com
> http://jerrywork.com
>
> 78 Royale with most everything done to modernize a GMC mechanically
> 77/94 Clasco bone stock and looks like it just left the Clasco facility
> Both drive equally as well.
>
> ===============
>
> Message: 10
> Date: Sat, 08 Aug 2015 10:42:12 -0600
> From: Emery Stora
> To: "gmclist@list.gmcnet.org"
> Subject: Re: [GMCnet] Welcome to Obama Care
> Message-ID:
> Content-Type: text/plain; charset=us-ascii
>
> The problem is that I technically am not covered by Medicare. The plan I have with Humana is a Medicare plan where I assign all Medicare payments to Humana and Medicare doesn't pay any claims directly to providers.
>
> I'll have to wait and see what happens with billings to me from the hospital.
>
> Emery Stora
> ===============
> _______________________________________________
> GMCnet mailing list
> Unsubscribe or Change List Options:
> http://list.gmcnet.org/mailman/listinfo/gmclist_list.gmcnet.org
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