I am sure there are a lot of people working on this - certainly some of them are well intentioned. The fact is, however, there are large numbers of lobbyists out there wanting their piece of the pie to continue, or, to get larger. The lobbyists have a huge affect on anything that is done in this country. ,, Also, there are a lot of smart, well-intentioned ordinary people out here, and on this board, who are telling of their own experiences, giving their opinions as well. I doubt anyone making decisions, will listen to them, but that doesn't mean their experiences, their ideas are not good or just as 'smart' as all those others who are thinking about it. My experience with Medicare is the exactly as I described and it is the only experience. I can't speak to what 'Medicare allows' - only what the doctor charged and what Medicare paid. I have no copy of the rules, only the medical bills. We will have to wait and see what Americans will tolerate in healthcare - because I think change is coming. I'm pretty sure some form of national healthcare is in the future - just don't know what kind. We do expect too much from medical care and too many procedures are done that I think should not. A lady I knew in her mid 80's was convinced to have bypass surgery. She was a pretty active, self-sufficient lady, and I don't know if she had had a heart attack, never heard of it, but it's possible. She lived 7 years after the surgery, but never recovered, those years were spent on dialysis, in a wheelchair and then dementia before she died. That was cruel - to her - to her family.

for 30 years I worked for Medicare. let's review a few things. by law the drs office has to accept Medicare assignment. that means whatever Medicare determines is reasonable and customary is the amount the doctor is owed. Ex: dr. charge: $300, Medicare approves $200, Medicare pays 80% of $200 which is $160, Aetna would pay 20% or $40 and no more money would be owed to the dr. Now the questions you must answer are 1. was the dr visit covered?if yes,had the deductible for 2008 been met? if not you would have to pay the decutible first, but most importantly did the dr off file the charges in a timely matter. Ask for proof from the drs office. DO NOT BE INTIMIDATED, if not they will have to eat their mistake. the proof they show you should be a payment voucher from Medicare showing the claim rec'd, paid, denied or applied to the deductible. email me if you have more ??? btw, it is too late to refile. Medicare is currently processing charges from 2010, all of 2009, and the last three months of 2008 (oct,nov, and dec) jingle2405@yahoo.com

I got caught in that--observation for 3 days with bleeding. There was no way I could go home, but they refused to ""admit" me. My insurance did pay everything, except the meds which I myself could turn in to the insurance company and they reimbursed me 80%. I did appeal it but got turned down. M.

You might want to google Senior Educators. It's an insurance service. I went to their web site and left my number and a few minutes later a very nice gentleman called me. He called me several times and helped me pick out a plan and no it wasn't the most expensive either. They can tell you about any plan that's available in your area and they will follow up later at the proper time and see if you want to change your plan.