question about medicare co pay

Hello all,

I am sorry if this is a repost of my question but I am having a bit of trouble finding my answer,

Been a while since I have been here, but I was in the process of doing all the things Medicare needs to be approved before I could see Dr hutcher.

Well that is done and saw the Dr. on 4/16/09

Today I received a letter from his office and it said I can schedule the surgery however, It informed me that since medicare doesn't preaporove I would need to make a payment before the surgery, to the doctor of $400 which is no surprise to me. I guess

But I have to sign a form stating if its not approved I will be responsible for the balance.. Again no surprise, but makes us very nervous

But....also states the full cost is well a very large amount for the total cost and I would be responsible for 20% if approved. thats $13,000 omg

Well now I am suprised.....

anyone ever been turned down after surgery by medicare?

I do have Diabeties and sleep apnea.. also high cholestoral, thyroid issues , well thats enough lol

So I think I will be approved, I would also think if the dr didn't think so he wouldn't have seen me. ..well I think

but I don't have that kind of money.... unless I read it wrong

I thought medicare deductable was something like a $1000 for a hospital stay?

Now I am nervous about going forward, I am afraid we would end of in bankruptcy if I wasn't approved. But also if I am...

My husband is very nervous about this, but I know I wouldn't live ,,,without it

Now I don't know what to do,

any advice or anyone can tell me how much the co-pay is if medicare approves?  I don't have a second insurance. Just Part B

Thanks for your help and hope I post this in the right place

update, is it possible that its 20% of the doctors care only?

I have Medicare as primary insurance. It is correct that Medicare does not pre authorizes for this insurance and that you will be required to sign a form stating that you know this and that if they deny payment, you will be responsible, not just for the surgery but for everything associated with the surgery, up to and probably including all pre op tests.

The $400 payment must be a "doctor by doctor" procdure as I was not required to pay anything to my surgeon for anything, either before or after my surgery. As far as copays. I paid none. Nothing for any doctor visit to the surgeon's office, nothing for the nutritionist, which happened to be a nutritionist at my diabectic dr, nothing for the pysch eval, which was with a licensed clinical social worker and nothing for any of the pre op testings they make you do right before your surgery, ekg, ultra sound, blood work and x rays.

I'm not sure how set you are on your doctor yet. If this payment to him is such a worry, maybe a consultation to another surgeon would be an ok suggestion. Just for more than one opinions.

As far as me. I had my lap RNY on April 30, 2008. I have gone from 318 to 181 with a few pound gain this week due to fluid retention from open heart surgery. I was on 1000 units of insulin up until the day I left the hospital and was taking 19 pills a day for breathing issues and heart problems. Most everyone goes through the wondering andthe questions. For me it was a test of weighing my options.

If you have anymore questions, feel free to ask and I will definitely try to help you as much as I can. Good luck!

wow your journey has been a tough one, I do wish you the best.

ok I went and searched on the medicare site.  From what I understand if correctly.

Part A is hospital and deductable is $1000 and some change

Part B is medical and it is pays80% and I pay 20% so it seems I pay 20% medical part, meaning drs and such.

see the letter phrased as if I pay 20% of the whole thing

I sent a e-mail to the person who sent me the letter to ask her some questions

As far as my Dr goes, Dr Hutchers is supposed to be real good.

I guess before I panick I should wait to see what she says. lol

Thank you for your response and good luck in your journey

up to this point I haven't paid anything yet, the Dr app, psy, or nutrt.

so maybe I should calm down lol

Take care

sounds like you are doing all the research. Our surgeons are in the same practice. I went with Dr Bautista for personal reasons. I have nothing negative to say about Dr Hutcher or anything positive either as I have had no dealings with him expect passings in the hallway at check ups. There are some on here that have chosen him and could speak of him but for me, Dr Bautista was THE CHOICE for me. However, their surgical practice is AWESOME! I love the entire staff and they generally, 99.9%, lol on top of everything, returning messages, calls, etc.

I know having to pay that percentage out seems like a big slam but think of it this way. Being on Medicare, prescriptions can be out of control priced. There is a great chance that you won't need them or as much of them after wards, and the amount of money spent on groceries or going out to meals is definitely reduced. Those right there can be your Medicare payment. Remember... where there's a will, there's a way.

It will come... just breath and think! of how great life will change aferwards!

Your so right, Thank you

Just worry that medicare would say no ,, after I had the surgery too

But I want to get healty more

Take care

Update,

I just received an e-mail from her and it is $400 is the 20% whewww

and still $1068 for hospital

now just hope medicare will approve or ouch

my surgery for 5/18  wow that was fast huh?