Thursday, July 18, 2019

Medical Insurance. EZ? I think not!

I recently had a surgical procedure performed. The billing is in. Due to my advanced age, I'm covered by Medicare (primary) and thanks to my career in the military, Tricare (secondary.)

The total billings were:

Billings approved by Medicare were:

Medicare paid:

Tricare paid:

The EOB I received from Tricare says that I'm responsible for:

So here are my not-EZ questions:
1.) If Medicare "approved" $178,825.61, why did they pay only $18,103.84?
2.) What is the status of the remaining $140,812.59?

I don't really want to ask anyone that second question!

1 comment:

Derek said...

Health "insurance" obtains discounts on work done, so they "approved" the charge, but then discounted it to the part they pay.

That is why health insurance is so expensive, as the doctors, hospitals and other caregivers have to increase their "costs" to make up for this dumb discount system. To prove this out, go to a new doctor, tell them you don't have insurance and ask to pay in cash. You will easily pay only 40% or LESS than their "market" rate.

Health insurance is a scam.