The best thing your friend can do is ask his surgeon.

I understand that it will be up to the
surgery center, but I want the best
possible information to go to them again.
Maybe they will take another look at doing
his surgery.

I just want a little help understanding what
this write up is saying.

Medicare is not my friend right now. I just went on it and it, along with my supplement, is costing about $100 more per month than I was paying for my private insurance with Blue Cross. It all has to do with income bracket. I had considered not taking Medicare, but if you don't and want to take it later, they penalize you for every month you didn't take it when you could. This is not a one time penalty, but will be tacked onto the premium every month thereafter for the rest of your life. Additionally, Medicare does not cover regular tests, such as cholesterol screening, nearly as often as Blue Cross did. I am not better off with Medicare.

Pauline, you must have had a very good employer subsidized Blue Cross plan if your Medicare supplemental is costing you more. I used to pay $1660 a month for private BC-BS and my supplemental is about $450 every three months. I love Medcare and am grateful to have it.

Maggie, I am assuming your friend is going to need an "inpatient" hospital stay for his brain tumor surgery (as opposed to "outpatient" or in/out surgery).

With that assumption, I can assure you that Medicare will cover his hospital stay @ a flat rate that is calculated based on the diagnosis & surgery performed, basically without ANY regard to how many days he is hospitalized nor if the hospital charges him $1000 for a single aspirin. (There are provisions for "outliers", but those are extreme cases and the patient doesn't pick up more of the cost,,,, it only impacts the hospital's Medicare reimbursement.)

To repeat: Medicare pays for inpatient hospital stay at a flat rate based on the diagnosis & surgery performed.

If your friend has Medicare part A and a supplemental insurance, his out of pocket expenses for the HOSPITAL BILL will basically be very minimal in the big scheme of things.

Now as to part B Medicare.... it is the part that pays for the dr's services (office visits, surgery, reading tests, etc.) as well as other OUTPATIENT services. If the dr or surgeon is a "Medicare participating provider" (accepts Medicare patients) then s/he will be reimbursed at a prescribed rate that is approved by Medicare and the supplemental insurance picks up the 20% (for example) of the approved amount not covered by Medicare.

To reassure you..... there is a HUGE amount of fear mongering going on, and much of it weighs heavily on the anxieties of seniors on Medicare. If your friend needs surgery NOW, none of this brouhaha going on in Congress or the media matters. (Nor will it actually impact him one way or the other.... things don't move that fast.) He, and you, need to not worry about the costs, charges, & the bill and concentrate on the things that he has control over... like what help he'll need in recovery, transportation, family & friend support, etc.

Hope this helps a bit. Best wishes for all.

My husband has Medicare and a supplemental plan. He just had surgery and was in the hospital for 4 days. Our co-pay was $200 per day and we had to pay the $800 up front, before the hospital would admit him. Does this sound reasonable? They did tell us that if we couldn't pay the money up front, we could fill out forma and if approved, could be put on a payment plan. We went ahead and paid because they told us that with my income from my job, we probably wouldn't be eligible for a payment plan???? BTW, I don't make much money at all and this up front payment was really a hardship for us.

Hi Pauline, I'm wondering where you heard about this "penalty fee" for not taking Medicare when you first qualified. My mom is 71 years old and still working enough to get insurance through her employer. Are you saying that for the six years she hasn't taken Medicare, she will be penalized? I hope that isn't true, but I'm off to find out. I have never heard of that. Why in the world wouldn't they want to keep as many people off of it as they could? Makes no sense!

. Are you saying that for the six years she hasn't taken Medicare, she will be penalized? I hope that isn't true, but I'm off to find out.

From the link below...
The late penalty exceptions apply if you are still working and have a group coverage from your employer that is primary.

Here is a link that might be useful: Medicare Eligibility and When to Sign Up

Thanks very much for that link Chemocurl; that not only helps with my mom's situation, but also helps me explain better to the senior citizen patients we see. I never fully understood what the different "parts" were for. Thanks again!! :)

Fran,

If my circumstances had been the same as yours, I would be tickled pink with Medicare also. Since they were not, please allow me a few minutes to be irritated with Medicare. I retired at age 61. I took two years of COBRA (you get an extra 6 mos. in TX if you worked for a TX based company). When my COBRA was up, I purchased a Blue Cross/Blue Shield policy that was as good as the policy I had when I was working. I paid $450. a month for it. It was an individual policy paid for only by me (no company involvement). I will be paying $550 a month on Medicare (including the supplement). My base Medicare premium is at the highest rate. Juellie, my insurance agent told me about the penalty. I'm assuming she was correct as it applies to me.

As Ann in Fla points out...there are Medicare supplemental policies that do have co-pays.

Medicare supplemental policies have several plans, benefits for each plan (a thru L) are defined by Medicare . The differences between insurance companies are cost and how they accept pre-existing conditions.