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Medical Stuff and Mystery Shopping

September 22nd, 2018 at 05:55 am

Yesterday morning I got a mammogram, and I already have the results. No sign of malignancies, but due to density it is recommended that I also start getting sonography. I'll have to check my insurance. Another reason to make a change. I did a little reading on my plan yesterday, and it looks like I would have to pay $295 per day just to be an in-patient in a hospital. That's not even counting rehab. That's terrible! I thought Medicare always covered hospitalization, but maybe that's only original Medicare and I have a Medicare Advantage plan. Changes will be made. More reading to do.

I spent the rest of the day on mystery shopping. I had to go back to the car dealer and get a business card -- which meant I had to listen to the spiel all over again and get back on the salesman's radar. It was a bit of a drive, too, thirty minutes away.

My other mystery shop was to go to a self-storage facility and rent a unit. Then I identified myself as a mystery shopper and got the whole thing cancelled. I felt kind of bad because the employee went through all this rigmarole for nothing. But his company contracted for this. The two shops, if I get full payment, will yield $70. No, not much for all the time I put in.

In the evening I went to GS1's flag football game under the lights. It turned quite cold and I was really ready to come home.

I'm taking GS2 to a complimentary screening of "Smallfoot" today, and then we'll drop in on GS1's baseball game.

I'm getting quite low on gas, so I should fill up today. I hate to do it, being so much over budget already, but I think I must. Safety first.



9 Responses to “Medical Stuff and Mystery Shopping”

  1. AnotherReader Says:

    Getting out of a Medicare Advantage plan can be difficult. Most states allow medical underwriting by the insurance companies for switching and you may not qualify. I suggest that everyone that thinks they will save money with a Medicare Advantage plan read this article.

    https://seniorsavingsnetwork.org/medicare-advantage/

    If you can find a way to switch back to original Medicare and a supplement plus a Plan D, your overall coverage will be better and you won't be bankrupted by a hospital stay.

  2. Joanie Says:

    open enrollment is coming up so you should be able to change. I have a plan F supplement and have been very pleased.

    Another thing about advantage plans surfaced when my mother was hospitalized and the Dr wanted to keep her longer. She had an advantage plan and the decision to allow her to stay was made by insurance co. bean counters NOT a doctor (and of course not allowed). The social worker at the hospital said that if mom had regular medicare and a supplement they would have gone with the Drs recommendation and allowed her to stay.

  3. CB in the City Says:

    This is very good to know. I have looked around a little and it appears that I can "disenroll" in Medicare Advantage between January 1 and February 14. They even call it MADP for Medicare Advantage Disenrollment Period. Then I can enroll in Original Medicare and a Part D plan. That would push my surgery back to February or March at the earliest. I have found out that SHIP (Senior Healthcare Insurance Program, part of the Illinois Department on Aging) provides Medicare counseling at our local Senior Center. So I'm going to call for an appointment on Monday.

  4. AnotherReader Says:

    It looks like Illinois has very unfavorable rules for switching to Medigap from an Advantage plan. It does not sound like you are eligible for guaranteed issue and you would have to go through medical underwriting to switch.

    http://insurance.illinois.gov/HealthInsurance/MedicareSupplement.pdf

    The SHIP people should be able to clarify this for you.

  5. AnotherReader Says:

    This article explains MADP. You can get out of the Advantage plan and purchase a Part D plan. However, there is no guaranteed issue for a Medigap plan granted through MADP. You would have to go through underwriting to switch plans.

    https://boomerbenefits.com/medicare-advantage-disenrollment-period/

  6. CB in the City Says:

    Thank you, AR. Very interesting. I am not the least bit surprised that Illinois has unfavorable rules for anything. Can you explain what it means to go through underwriting?

  7. AnotherReader Says:

    It's the same process as buying insurance on the open market. You have to fill out a detailed application, including a list of all of your medical issues. You give the insurer the right to look at your medical history. They make the decision about whether they will accept you as a customer.

    I'm not sure but I think you can file multiple applications. Your SHIP counselor should advise you on that. You apply a couple of months in advance with an enrollment date in the MADP.

    You might call a licensed insurance agent to discuss your options as well. Both the Boomer Benefits people and the Senior Savings Network people are licensed agents selling policies nationwide. It might be worth a call to both to get their take on your situation.

    In your shoes, I would get out of the Advantage plan ASAP. You don't want the insurance company sending you home from surgery too soon or cutting short your rehab benefits. I would delay surgery until I had made the switch. You will also have a better choice of doctors, including surgeons, under original Medicare and the supplement.

  8. rob62521 Says:

    The whole Medicare issue is difficult to comprehend. I hope you can find a better plan. That's a lot of money to shell out if you have to be hospitalized. Ouch.

    Sorry about all the struggles with the mystery shopping. But, $70 is $70.

    We try to keep our gas tanks at half or more. Supposedly gas prices are going to go up as they start the winter blend and there will be a "shortage" until it completed. But oil prices have been increasing a bit, and any excuse to raise the gas prices, the stations around here do it. I swear they have a phone tree because within a few hours, they all are the same price.

  9. AnotherReader Says:

    In your financial situation, you need to know the costs of the hip surgery before you get it done if you stay on Medicare Advantage. There are substantial out of pocket expenses for a surgery and hospitalization in Medicare Advantage plans.

    High out of pocket costs are one of the ways plan premiums are kept low. OOP costs can be over $6,000 annually with an Advantage plan. You will want to get a detailed estimate of your share of the cost before you move forward with the surgery.

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