Freewill
Platinum Member
- Oct 26, 2011
- 31,158
- 5,072
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My doctor wants to replace my CPAP machine. Unlike many I like my machine it helps me breath at night and I used it everynight. So being on medicare i have an advantage plan that pays 80percent for durable goods such as a cpap machine.
So i call and am told it is 75 dollars up front and 23 dollars a month rl for 13 months. Which is 80%. So doing the y math 12 X 23 + 75 = 351 dollars for me which is 20 percent. So the total cost would be 351/.20 = 1755 dollars. The insurance company pays 1755-351=1404. Or so you would think. Medicare pays, guess what, 80 percent so the insurance company pays nothing and I bet they get a cut from how much it costs. So the more it cost the better for them, they can only win. They don't really care what we pay or even how much the thing really costs. They want it to cost more, in my opinion.
So I call them and say, "I went on line and found cpap machines that are very nice for well under 1000 dollars. Ones I could use were about 359 dollars. They didn't even entertain the idea of me buying one on line and getting them to reembursh me even if it looked like they would save 1000 dollars. Then the scam described above came to mind.
So I call medicare and explained the same thing and how I think they are being ripped off. I might as well been talking to my cpap machine. The woman was nice enough but I think she thought i would be calling about psychological coverage.
So there you have it, this one item costing much more than what it is actually worth and there isn't a stinking person in the world that will do anything about it. Or maybe they can't.
I haven't given up yet. There are some dentist in the network that the insurance says they supply cpap machines although their website pushes prosthesis. I am going to call and tell them that they can buy one on line and bill the insurance company 1000 dollars. I then will save 150 dollars my insurance will saves about 600 dollars and the doctor makes whatever he can buy it for under the 1000 dollars. Sounds like a win/win for everyone involved. But I seriously doubt that will happen.
It is not that I am cheap but I don't like throwing money away to greedy health care providers.
So i call and am told it is 75 dollars up front and 23 dollars a month rl for 13 months. Which is 80%. So doing the y math 12 X 23 + 75 = 351 dollars for me which is 20 percent. So the total cost would be 351/.20 = 1755 dollars. The insurance company pays 1755-351=1404. Or so you would think. Medicare pays, guess what, 80 percent so the insurance company pays nothing and I bet they get a cut from how much it costs. So the more it cost the better for them, they can only win. They don't really care what we pay or even how much the thing really costs. They want it to cost more, in my opinion.
So I call them and say, "I went on line and found cpap machines that are very nice for well under 1000 dollars. Ones I could use were about 359 dollars. They didn't even entertain the idea of me buying one on line and getting them to reembursh me even if it looked like they would save 1000 dollars. Then the scam described above came to mind.
So I call medicare and explained the same thing and how I think they are being ripped off. I might as well been talking to my cpap machine. The woman was nice enough but I think she thought i would be calling about psychological coverage.
So there you have it, this one item costing much more than what it is actually worth and there isn't a stinking person in the world that will do anything about it. Or maybe they can't.
I haven't given up yet. There are some dentist in the network that the insurance says they supply cpap machines although their website pushes prosthesis. I am going to call and tell them that they can buy one on line and bill the insurance company 1000 dollars. I then will save 150 dollars my insurance will saves about 600 dollars and the doctor makes whatever he can buy it for under the 1000 dollars. Sounds like a win/win for everyone involved. But I seriously doubt that will happen.
It is not that I am cheap but I don't like throwing money away to greedy health care providers.
