I had an appointment yesterday with my tax accountant who is over 65 and on Medicare. She is my accountant but not my client, but she asked me about a bill she got from her dermatologist. The bill showed the charges for her treatments in the office, and it showed what Medicare paid and what her Medicare supplement paid. It looked like the doctor’s office was “balance billing her” – though I didn’t look that closely at the bill. I told her to call the doctor’s office and ask for an explanation of the bill.
One clue I did not pick up on: The amount due was $162.
Second clue: This lady has a Plan N Medicare supplement.
As I drove away from the appointment, my cell phone rang. It was my accountant calling to tell me she had spoken with the doctor’s office about the bill. They told her she has a deductible in her coverage, and that’s what the $162 is.
Duuuuuuh! How could I forget that? Medicare Part B has a $162 deductible, and Plan N does not cover it. Plan N has a lower premium than a Plan F or C because a person must pay a $20 co-pay when they go to a doctor’s office. They also pay a $50 co-pay if they go to the emergency room. And they pay the Part B deductible each year ($162 in 2011).
I am an insurance agent and I forgot about the Part B deductible not being covered by Plan N. (Of course, I was not in my working-and-explaining-Medicare-mode when I was meeting with my tax accountant.) I can see lots of folks getting Plan N for a lower monthly premium and then having greater confusion when they get their medical bills.
I usually suggest people get a Plan F Medicare supplement. “Think F as in full coverage”, I say. With Plan F they don’t have to worry about co-pays and deductibles because Plan F fills all the gaps in Medicare. I have had several clients who were diagnosed with cancer, and they called me specifically to tell me how grateful they were to have a Plan F Medicare supplement because they never had to think about their medical bills.
I just thought I’d pass on this tidbit of wisdom I gained this week.