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The Water Cooler
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Medicare 2025 Discussion
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<blockquote data-quote="okcBob" data-source="post: 4343717" data-attributes="member: 45783"><p>Well, you already know the coverage & network going in. So, that’s not a surprise. If your hospital & docs are all in network, it’s not an issue. Plus, if you have an Advantage PPO instead of an HMO, your network isn’t restricted.</p><p></p><p>I’ve seen lots of traditional Medicare patients get hit with huge bills and have their options for post acute care limited when they run out of their lifetime reserve days. Also seen them get denied for SNF transfer because of Medicare episode of care rules. Traditional MCR can limit your coverage too.</p><p>So, it really depends on your health & what benefits you want to have. Compare both & ask what coverage am I getting for my money, & what coverage do I need? Do i have expensive meds, travel a lot, have frequent hospitalizations or procedures? It all plays into that decision.</p><p></p><p>Add: just remembered, we also see traditional MCR patients get denied transfer to LTACH’s because they don’t meet the MCR requirement for ICU days.</p></blockquote><p></p>
[QUOTE="okcBob, post: 4343717, member: 45783"] Well, you already know the coverage & network going in. So, that’s not a surprise. If your hospital & docs are all in network, it’s not an issue. Plus, if you have an Advantage PPO instead of an HMO, your network isn’t restricted. I’ve seen lots of traditional Medicare patients get hit with huge bills and have their options for post acute care limited when they run out of their lifetime reserve days. Also seen them get denied for SNF transfer because of Medicare episode of care rules. Traditional MCR can limit your coverage too. So, it really depends on your health & what benefits you want to have. Compare both & ask what coverage am I getting for my money, & what coverage do I need? Do i have expensive meds, travel a lot, have frequent hospitalizations or procedures? It all plays into that decision. Add: just remembered, we also see traditional MCR patients get denied transfer to LTACH’s because they don’t meet the MCR requirement for ICU days. [/QUOTE]
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