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Medicare is a maze of pitfalls, traps and consequences wrapped in strange language and acronyms. This book will guide you over, under, around or through all of the traps lying in wait for you within the Medicare maze. In a short, enjoyable 2 or 3 hour read, you will gain an education about the problems and the solutions within the care and cost systems that many professionals struggle to comprehend. You will become a truly informed consumer, prepared to grapple with your own set of constraints as you pass the milestone of “Happy 65th!”

Decisions you make at this critical time, when most new seniors are totally unprepared for the complexities ahead, will either help you or hurt you for many years to come. Many of those decisions are irrevocable. The solutions are affordable and relatively painless, for the well-informed. Read this book and find them.

This is Rick Mortimer’s third book on Medicare, fully updated for the 2019 plan year. His experience writing about this complex subject, along with his many years in finance and insurance, allow him to quickly get to the essence of each potential problem area, in simple language.

Complexity and confusion are the earmarks of this system. Words often have quite different meanings than in simple English.

One small example: the word “covered”. When we’re told that a procedure or treatment or visit is covered by Medicare, our normal English interpretation is that our costs are taken care of.

This is not the case, not by a long shot. Covered, to the folks at Medicare, means that they will pay some part of the cost, leaving us with sometimes huge out-of-pocket expenses. And figuring out what part they will pay is also far from simple.

To illustrate, consider the medical bills “covered” under Part B of Medicare, the piece that encompasses doctors’ bills and outpatient treatments, for a common senior procedure — a knee replacement. Most of these are now done in outpatient surgery centers, so your doctor will say, and Medicare will confirm, that an outpatient knee replacement is all “covered” by Part B. If you merely accept that language as plain English and assume that you can have the procedure without cost, you are in for a massive set of surprises.

“Covered” under Part B means, at best, 80% of the costs are actually paid by Medicare. You pay a monthly premium of $135.50 in 2019 for Part B coverage. Then you pay a deductible, $185.00 in 2019, upon your first use of Part B benefits in the calendar year. But the biggest surprise of all is that you still have to pay 20% of ALL the Part B charges — plus an additional (up to) 15% for “excess charges” if your doctor elects to bill you for more than Medicare will pay

Run the numbers: costs for a knee replacement will vary widely with doctors, facilities, and your specific condition and complications. To get into the ballpark, we looked at some reputable websites for data. Howmuchisit.org quotes a range of $40,000 to $80,000, all-in. Healthline.com puts it at $57,000. These amounts do not include the extensive after-care required, including a lot of physical therapy, also covered by Part B. If nursing home or in-home health care is required for you, these charges may or may NOT be covered at all, but that’s a subject for another discussion.

We will be very optimistic and estimate that your final tally comes to $60,000, entirely “covered” by Part B. So before you get to skip on home from the outpatient center with your new knee, you will have to lighten your wallet by at least $12,185. Assuming that there are no complications. If the doc thinks his work is worth billing you excess charges, add many thousands more.

Is that a check you can afford to write, or will you have to grind about painfully on your old knee for the extra years it might take to accumulate that much cash? Do you feel “covered”?

Read this book. Hold on to your money. And get the care you need, when you need it.

ASIN ‏ : ‎ B07JYHBZLZ
Publisher ‏ : ‎ Next Mountain Publishing (October 28, 2018)
Publication date ‏ : ‎ October 28, 2018
Language ‏ : ‎ English
File size ‏ : ‎ 10724 KB
Text-to-Speech ‏ : ‎ Enabled
Screen Reader ‏ : ‎ Supported
Enhanced typesetting ‏ : ‎ Enabled
X-Ray ‏ : ‎ Not Enabled
Word Wise ‏ : ‎ Enabled
Sticky notes ‏ : ‎ On Kindle Scribe
Print length ‏ : ‎ 286 pages