9 comments on “FAQ’s non conical

  1. Thank you for your advise to get Plan F many years ago.

    With all my husband’s illnesses and hospitalizations, we have had very little out of pocket expense.

  2. 1 I’m finding it difficult to comprehend all the plans, providers, and options.

    2 I’m leaning toward Anthem’s Plan F or F Innovative

    3 I’d like to be able to go out of network, and see specialists without a referral.

    4 I’m ok with a high-deductible.

    5 I don’t have any significant health issues, but would like to have copay coverage if I become hospitalized.

    6 What about Part D Rx Prescriptions?

  3. what the limitations of just having Medicare part a and b

    Is there an annual out of pocket maximum that includes maximum on copay and deductibles?

    If I am understanding correctly there is a deductible for certain time periods in the year, then we pay 20% of services which may or may not be billed at a contracted rate.

    • See above screen shot of a Plan F summary of benefits, click on it and then it will give you more examples of what Medicare Pays or leaves out, what plan F would pay and then what you would pay after both plan F and Medicare pay.

      You would have to get Part D Rx to cover out of hospitial prescriptions.

      Medicare doesn’t have an annual out of pocket limit. That’s why Medicare Advantage or Supplement Plans are so popular. Those do… check exact summary of benefits or EOC for details.

      Deductibles and 20% are confusing. That’s why I use the Plan F chart to see what is covered or not and what % you pay. The main confusion I think your having is the answer is different for Part A Hospitial and Part B Doctor visits.

      Click here https://www.medicare.gov/physiciancompare/ or above when I update this page to find Medicare doctors. Medi Gap has the same list, any MD… Medicare Advantage uses and HMO type list. Check with each Insurance Company and their specific plan.

      See this page about Medicare Contracted rates, 15% limitation and the requirement if a MD doesn’t take Medicare, he has to inform you and get your written consent.

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