Well, just got my grandma, who is 98 years old, (lives with me) bill in the mail for a simple office visit to the doctor. $48 for CBC $65 for CMP, $93 for a vitamin B12, $182 for a Vitamin D, $13 for a venipuncture total bill was $401. For lab work on a 98 year old. Come on people!!!!
Do not do this to me when I am 98 years old. My gosh!! Unbelievable. And its not the doctor's fault its skanky blood sucking lawyers that want to fault doctors for every little test they didn't do. I think it should be the opposite, we should start suing for dumb blood work that is ridiculous.
I told my two kids who are teenagers about this bill and my husband and I both said "do not do this to us!!!!" Save the $400 for my grandkids' medicare.
Stupidest thing in the world was a hospice visit I made to a family putting dad through the meat grinder on dialysis. $50,000 a month and he had absolutely no quality of life at all, pain, confusion, could not do one single ADL, family couldn't name one thing that is good about prolonging the inevitable, but they still refused to start hospice and stop the dialysis. Please don't do this to me, I have told every person I know not to do this to me!!
Specializes in Complex pedi to LTC/SA & now a manager.
My grandmother, 88, at the time had a young PCP clearly trying to hit metrics pushing anti cholesterol drugs for a borderline level, Pap smear, mammogram, colonoscopy and other "preventative " testing. She was confused. I was called. She had terminal COPD. I found her a new PCP. The side effects from the Lipitor alone were unbearable for her never mind personal invasive testing that we would do nothing with positive results.
We refused routine labs as Medicare required an ABN notice as they were unnecessary. Doc ordered them as she kept a traditional BCBS plan at the time that would pay. (With a hefty deductible!). New doc tested and treated for comfort.
Specializes in Psych, Addictions, SOL (Student of Life).
Well, just got my grandma, who is 98 years old, (lives with me) bill in the mail for a simple office visit to the doctor. $48 for CBC $65 for CMP, $93 for a vitamin B12, $182 for a Vitamin D, $13 for a venipuncture total bill was $401. For lab work on a 98 year old. Come on people!!!!
Do not do this to me when I am 98 years old. My gosh!! Unbelievable. And its not the doctor's fault its skanky blood sucking lawyers that want to fault doctors for every little test they didn't do. I think it should be the opposite, we should start suing for dumb blood work that is ridiculous.
I told my two kids who are teenagers about this bill and my husband and I both said "do not do this to us!!!!" Save the $400 for my grandkids' medicare.
Stupidest thing in the world was a hospice visit I made to a family putting dad through the meat grinder on dialysis. $50,000 a month and he had absolutely no quality of life at all, pain, confusion, could not do one single ADL, family couldn't name one thing that is good about prolonging the inevitable, but they still refused to start hospice and stop the dialysis. Please don't do this to me, I have told every person I know not to do this to me!!
Under provisions in the ACA Medicare will be gradually phased out and certain tests which are considered routine as opposed to related to acute conditions will not be covered either. Check into Your grandma's Medicare. She needs to have supplemental insurance and also Part B and D which many people do not. It may be too late for her but everyone should invest in Long term care insurance as Medicare only covers 100 lifetime LTC days in a facility after that it's cash pay. We have to break this news to families everyday. At $650.00 a day it adds up. Frankly I'd rather my family take me to Cancun in my final days and let me sit on a beach drinking Margarita's
Specializes in NICU, PICU, Transport, L&D, Hospice.
Under provisions in the ACA Medicare will be gradually phased out and certain tests which are considered routine as opposed to related to acute conditions will not be covered either. Check into Your grandma's Medicare. She needs to have supplemental insurance and also Part B and D which many people do not. It may be too late for her but everyone should invest in Long term care insurance as Medicare only covers 100 lifetime LTC days in a facility after that it's cash pay. We have to break this news to families everyday. At $650.00 a day it adds up. Frankly I'd rather my family take me to Cancun in my final days and let me sit on a beach drinking Margarita's
Hppy
What is the provision in the ACA which requires or will cause a "gradual phase out" of Medicare?
Can you please provide a link as I was not able to verify that comment. I certainly can find language which discusses phasing out the "donut hole" but not the entire program.
Medicare is the one that paid $400 for the bill. Thats only the tip of the iceberg I know that there are sooooo many treatments that are absolutely unecessary!! and bankrupting medicare.
Medicare didn't actually pay $400 for those tests. Labs and other billing entities will show on their bill what they charge, but medicare doesn't pay what they charge if that exceeds their maximum allowable fee, which for a CBC is about $14, for a B12 level it's $21. There might be some insurers that will pay $400 for those test, but medicare caps their fees and requires medicare participating providers to accept those fees and cannot seek the remainder from the patient.
I'm not sure how the doctor did the labwork without your knowledge or your grandmother's knowledge, you didn't notice someone coming in to draw blood?
Under provisions in the ACA Medicare will be gradually phased out and certain tests which are considered routine as opposed to related to acute conditions will not be covered either. Check into Your grandma's Medicare. She needs to have supplemental insurance and also Part B and D which many people do not. It may be too late for her but everyone should invest in Long term care insurance as Medicare only covers 100 lifetime LTC days in a facility after that it's cash pay. We have to break this news to families everyday. At $650.00 a day it adds up. Frankly I'd rather my family take me to Cancun in my final days and let me sit on a beach drinking Margarita's
Hppy
There is no "gradual phase out" of medicare under the ACA or anything else. The requirements for a supporting diagnosis or other data for tests and procedures is actually not new. There is no such thing as a 100 day lifetime limit for LTC care under medicare. There is a 100 day limit for SNF rehab care per benefit period, which is pretty reasonable. The purpose of this coverage is for patient who have a recoverable condition that just needs a period of rehab in a SNF. If the patient has a condition or illness that requires short term SNF care and uses 100 days in the SNF and then later has another condition or illness that 100 day limit starts over.
Specializes in Psych, Addictions, SOL (Student of Life).
There is no "gradual phase out" of medicare under the ACA or anything else. The requirements for a supporting diagnosis or other data for tests and procedures is actually not new. There is no such thing as a 100 day lifetime limit for LTC care under medicare. There is a 100 day limit for SNF rehab care per benefit period, which is pretty reasonable. The purpose of this coverage is for patient who have a recoverable condition that just needs a period of rehab in a SNF. If the patient has a condition or illness that requires short term SNF care and uses 100 days in the SNF and then later has another condition or illness that 100 day limit starts over.
The ACA bill is over 1400 pages long and I read the whole thing back when they were trying to get people to agree to the thing. The Medicrte phase out will occur due to all people over 21 being required to have their own health insurance or risk criminal penalties which BTW start going into effect next year. As for the 100 day lifetime long term care benefit - it does exist. I work in LTC and after 100 days those without long term care insurance go on a cash pay basis. My own mother has to pay almost $4,000.00 a month since she has maxed out her Medicare and in any Case Medicare does not cover custodial care. Fortunately my dad left her with what we hope is plenty of money to see her through her days. After 100 day a person can appeal to Medicare but I have yet to see anyone win their case.
You really should see the look on the people's faces when they are told their parent's care is no longer covered - it's so sad.
The ACA bill is over 1400 pages long and I read the whole thing back when they were trying to get people to agree to the thing. The Medicrte phase out will occur due to all people over 21 being required to have their own health insurance or risk criminal penalties which BTW start going into effect next year. As for the 100 day lifetime long term care benefit - it does exist. I work in LTC and after 100 days those without long term care insurance go on a cash pay basis. My own mother has to pay almost $4,000.00 a month since she has maxed out her Medicare and in any Case Medicare does not cover custodial care. Fortunately my dad left her with what we hope is plenty of money to see her through her days. After 100 day a person can appeal to Medicare but I have yet to see anyone win their case.
You really should see the look on the people's faces when they are told their parent's care is no longer covered - it's so sad.
The ACA bill is over 1400 pages long and I read the whole thing back when they were trying to get people to agree to the thing. The Medicrte phase out will occur due to all people over 21 being required to have their own health insurance or risk criminal penalties which BTW start going into effect next year. As for the 100 day lifetime long term care benefit - it does exist. I work in LTC and after 100 days those without long term care insurance go on a cash pay basis. My own mother has to pay almost $4,000.00 a month since she has maxed out her Medicare and in any Case Medicare does not cover custodial care. Fortunately my dad left her with what we hope is plenty of money to see her through her days. After 100 day a person can appeal to Medicare but I have yet to see anyone win their case.
You really should see the look on the people's faces when they are told their parent's care is no longer covered - it's so sad.
Hppy
That's pretty out there even for ACA related hysteria.
The entire bill including reconciliation language is 955 pages with gigantic margins, headers, and footers.
There is no medicare phase out anywhere in the bill, requiring people to carry insurance who can afford it is not phasing out medicare, and there are no criminal penalties for not carrying insurance, they are tax penalties and they started before this year.
Medicare part A does not cover long term care for custodial reasons, not for one day or 100 days. The only 100 day limit is to short term skilled nursing care for the purpose of recovering from an illness or condition, and that's not a lifetime limit, it's a limit per qualifying episode of illness or condition.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Medicare is the one that paid $400 for the bill. Thats only the tip of the iceberg I know that there are sooooo many treatments that are absolutely unecessary!! and bankrupting medicare.
I immediately related to your post because of what I have observed happening with my friend's 92 year old dad.
I should preface that I have not studied the the arcane fine print of medicare reimbursement. I am very familiar with how billing and coding have changed in family practice settings as well as admittedly anecdotal observation of what is typically ordered in routine follow-ups for non-acutely ill geriatric patients.
It doesn't stop at office visits. They order a variety of home visits for services such as PT where the Physical Therapist charges for telling the 92 year old guy to make a couple of cruises around the the wall between the kitchen and dining room several times a day. You need PT for that? I could go on but my head might explode.
I guess it's the stuff they will pay for that makes me think the math at some point has to go ass-over-teakettle.
I'm absolutely in favor of the ACA. What I'm seeing is really discouraging though.
Medicare is not being phased out. I'm not sure when anyone would get that idea. And I am one of the biggest skeptics as far as the ACA is concerned. OP, did the physician not explain the purpose of the bloodwork to your grandmother? Was it really not necessary? As we do not know your grandmother or her health history, I don't think any of us can make an educated statement as to whether that testing was not needed. I will assume that since she is 98 years old, she has done something correct to have lived this long. Maybe it has to do with taking care of herself. Since the tests were covered in a doctor's visit, it was her Medicare supplement policy that covered it, not actual Medicare. Medicare itself only covers hospitalizations. At that, it covers about 80% where the patient pays the other 20%. A supplement plan which is usually Part B and D is what covers office visits, laboratory testing, medications, pretty much all of the other stuff. There are tons of plans out there and they are offered by different insurance companies. They range in cost, some costing as little as nothing for an HMO, where others cost $30-$60 a month which can automatically be deducted out of the your social security check. The more you pay out of pocket a month, the more options you get with coverage. The big thing to look at is the prescription coverage. It can be very confusing. Mine is actually through United Health Care. I don't think that actual Medicare has paid a dime for me since I went on it a few years ago. All of my stuff has come out of my supplement policy. I pay way more for the actual Medicare coverage a month. As I transition back into the workplace, I have been fortunate that my Medicare coverage has been able to stay in plus for a period of time while I get a job with benefits. So, I do have an inner knowledge about how it works.
I was trying to understand the thought process that by requiring our citizens to carry health insurance is phasing out Medicare. Medicare is for those 65 and older and people on disability. There are good things with the ACA and bad things with it. The OP wonders why it costs so much money to have lab tests done. There is a very good reason for it. People who up until now that have not had health coverage but had something tragic happen to them, are not able to pay their bills. So they don't. There are many people in this country who do not pay medical bills which causes the costs to rise exponentially on everything down to the Tylenol. Sometimes it's on purpose to not pay and others it's due to tragic circumstances. When someone needs an emergency procedure done, the hospital does not ask for payment up front. If it so happens you are unconscious, they can't even get your insurance card from you. And if you tell the hospital you don't have insurance, the hospital doesn't say we won't treat you. They are not allowed in an emergency situation or if you are pregnant and going into labor.
There are people not poor enough to be able to get Medicaid but do not make enough to buy insurance. That's where the catch-22 happens and people cannot afford to pay the bills. One of my best friends in the world had just started a new job about ten years ago. She was a couple of days shy of the 90 day mark that made her eligible for their insurance and she was in terrible abdominal pain. She had it for several months and she was trying to wait for the insurance kicked in. It was finally so bad I drove her to the ER. Turns out, she had a grapefruit size tumor in her uterus. Now, it was considered a pre-exsisting condition. There was no time to spare in her case. Surgery needed to be done immediately. Since she did not qualify for FMLA, her company had to terminate her until she could come back to work. She had 5 kids at the time and she could not work and needed life-saving surgery and radiation. She got it all taken care of and she survived. She finally ended up back at work. But with hundreds of thousands of medical debt and no way to pay it. She had to declare medical bankruptcy. So, essentially the tax payers paid for it. The doctors and hospitals did not get their money but they treated her anyway. She was in a terrible situation at the time that was no fault of her own. It's a vicious cycle and it is why everything is so expensive. I think this was Obama's way to try and fix the problem. Unfortunately, a plan like this takes years and years of figuring and planning and not just throwing something on the table because of some campaign promises. And that is what happened. A very confusing, bad program. It does have some promise, it just needs a severe overhaul and made into something that makes sense.
I know that I am pretty well-versed in health insurance and the different programs and it all gets confusing to me. I was licensed to sell health insurance years ago, but wading through the ACA and Medicare supplement policies is crazy and hard for me to understand. I can't imagine how hard it is for the elderly and people who do not have a lot of education.
I do know that Medicare will be revamped as the baby boomers age and our population is dwindling and not sending as many people into the workforce. It is not going away though. If somebody though can post links to what they are saying, I will be glad to take a look and research it. But please do not spread propaganda that is not true around to patients and their families.
As far as LTC goes, Medicare does only pay for a certain amount of time. At that point it is expected that if this is a permanent situation for the person, all assets need to be sold and used for payment first, then the person can apply to Medicaid and they will pay for it. If they are going into LTC permanently shouldn't that be what is done anyway? If the person has no way to pay, the government can't just foot the bill while they retain a home, and savings, and all of that. That all needs to be depleted first. When the person has less than I think it's $1500 in assets, then Medicaid can kick in. Medicare is just designed to pay for rehabilitation and short stays, not permanent. One of my close friends just went through this with her mom. Her mom did not want to sell her house. I can understand that, but she has dementia and will not get any better and this is the only solution. Her daughter tried to take care of her but it was difficult. The painful decision had to be made to sell the house and put her in the nursing home. It was a very painful decision for my friend to make, but there are options.
So,respectfully,why did you let them draw those labs?
You do realize that if a patient is alert and oriented the POA paper is basically just a piece of paper? Until she can't speak for herself, the granddaughter has no legal right to make decisions.
The ACA bill is over 1400 pages long and I read the whole thing back when they were trying to get people to agree to the thing. The Medicrte phase out will occur due to all people over 21 being required to have their own health insurance or risk criminal penalties which BTW start going into effect next year. As for the 100 day lifetime long term care benefit - it does exist. I work in LTC and after 100 days those without long term care insurance go on a cash pay basis. My own mother has to pay almost $4,000.00 a month since she has maxed out her Medicare and in any Case Medicare does not cover custodial care. Fortunately my dad left her with what we hope is plenty of money to see her through her days. After 100 day a person can appeal to Medicare but I have yet to see anyone win their case.
You really should see the look on the people's faces when they are told their parent's care is no longer covered - it's so sad.
Hppy
Then the facility social workers are not doing their jobs. They need to steer people toward applying for Medicaid, which DOES cover custodial, long term care (and also room and board for Hospice, by the way) when the money starts to run out. Facilities now are reluctant to accept "PA pending" patients, so if everything is in place and Mom qualifies for Medicaid, there's no worry-facilities do have limited Medicaid beds, though, so getting things rolling early can help assure Mom can stay put.
JustBeachyNurse, LPN
13,957 Posts
My grandmother, 88, at the time had a young PCP clearly trying to hit metrics pushing anti cholesterol drugs for a borderline level, Pap smear, mammogram, colonoscopy and other "preventative " testing. She was confused. I was called. She had terminal COPD. I found her a new PCP. The side effects from the Lipitor alone were unbearable for her never mind personal invasive testing that we would do nothing with positive results.
We refused routine labs as Medicare required an ABN notice as they were unnecessary. Doc ordered them as she kept a traditional BCBS plan at the time that would pay. (With a hefty deductible!). New doc tested and treated for comfort.