Medicare and Supplemental ins ( FEP Blue) question

[Anonymous]

Have Medicare Part A and B with BCBS as supplemental.

Surgery Bill including the entire surgical center bill: 21, 000 (a rotator cuff repair)
Medicare paid: 1,317
BCBS paid: 200.00 ( Federal FEP Blue)

What?
And no, we are not being billed for the rest. But- what on earth is this amount for a $21,000 surgery?
How do practices stay in business?

Looking through all the EOBs this year, our first year in Medicare- largely the same. One of my specialists is actually paid abouf 100.00 for a 400.00 bill and the list goes on. Some regular GP visits for both of us are just not even paid at all, or still pending for a year, or about 20 bucks here and there.
(The oncologist for my dog is paid more than this- and frankly I'm not complaining, he is great.)

But, what don’t I understand as a novice Medicare subscriber? Maybe we should have not ever signed up with Medicare and just kept the BC insurance.

I have asked a similar question here before, but it did not really answer this scenario, this is a new claim.

[Anonymous]

No one ever look at their EOBs? Do it- you'll be shocked.

[Anonymous]

Others are paying outrageous amounts. It is a feature of our broken system.

[Anonymous]

The system is so stupid. Sometimes having insurance reduced a bill by 90%, sometimes it increases a bill by 90%.

[Anonymous]

Not getting Medicare won't get you better coverage. Look at old EOBs from working days.

Some providers do mot contract with Medicare and sre out of network for CareFirst. In which case CareFirst will pick up some subject to deductibles, copays coinsurance and allowed amount and provider CAN balance bill. Find out in advance. Advantage can be a better surgeon for example.

But lots of good doctors do take Medicare and CareFirst. Your BCBS will be similar.

[Anonymous]

Anonymous wrote:Not getting Medicare won't get you better coverage. Look at old EOBs from working days.

Some providers do mot contract with Medicare and sre out of network for CareFirst. In which case CareFirst will pick up some subject to deductibles, copays coinsurance and allowed amount and provider CAN balance bill. Find out in advance. Advantage can be a better surgeon for example.

But lots of good doctors do take Medicare and CareFirst. Your BCBS will be similar.

True but at least OP doesn't have to pay two premiums.

[Anonymous]

Anonymous wrote:Not getting Medicare won't get you better coverage. Look at old EOBs from working days.

Some providers do mot contract with Medicare and sre out of network for CareFirst. In which case CareFirst will pick up some subject to deductibles, copays coinsurance and allowed amount and provider CAN balance bill. Find out in advance. Advantage can be a better surgeon for example.

But lots of good doctors do take Medicare and CareFirst. Your BCBS will be similar.

I’ll clarify.These providers do take CareFirst BCBS and Medicare. Medicare is primary. I don't owe anything else. Here's my complaint:
Medicare pays basically nothing and so does BCBS. Look above on my post-they paid a ridiculous amount for a surgery. BC also added a tiny amount. Sometimes BC doesn't pay anything at all and claim the practice has an agreement with Medicare. Astonishing!

When we were BCBS as primary and Medicare as secondary, BC paid close to bill amount and Medicare kicked in a bit. Now these providers really aren't paid at all. I should have stayed with just BCBS and not signed up with Medicare.

[Anonymous]

Anonymous wrote:The system is so stupid. Sometimes having insurance reduced a bill by 90%, sometimes it increases a bill by 90%.

I just cannot figure out the game.