Gene had a medical emergency and his wife Lucille, drove him to the local hospital emergency facility. They both knew that the hospital was in their Medicare Advantage network and had no worries about being responsible for out-of-network financial charges.
Once Gene was checked into the emergency room and the emergency staff identified his condition, they realized they did not have the specialist on duty for his medical condition and could not treat him.
After stabilizing Gene, the emergency room doctor explained to them both exactly what the issue was and reassured them that the staff was searching for a doctor on duty at another hospital who could treat his condition. Within an hour the doctor returned and expressed that they indeed had found a doctor on duty and that the hospital did have a bed for him. It seemed that there was a double jeopardy in that they could have found a doctor, but the hospital might not have had a bed for him. Lucky for Gene they had a doctor and a bed for him.
An ambulance transferred him to the next hospital and the doctor was waiting. As Gene was being treated the hospital administrator had come to Lucille and had her sign forms and afterwards Lucille was very concerned that she had to sign a waiver stating that they would be responsible for the medical bill if Gene’s Medicare Advantage plan would not pay. Lucille called Gene’s Advantage plan and confirmed that the new hospital was not in Gene’s plan network. Now she begins to worry about the financial exposure they could be responsible for, above any normal co-pays.
As Gene recovered from the surgery over the next few days, Lucille could not contain her worries about the medical bills and expressed her concerned to Gene. Gene had one response “Call David at American Retirement Advisors, he’ll have the answer.
As soon as we learned of their financial fears, we assured them that they would only be responsible for their normal hospital co-pays which was a flat fee of $200 a day for the first seven days on their plan. So, no matter what the hospital bill, $1400 was the most they would have as financial exposure.
Needless to say, Lucille as well as Gene were relieved.
Got questions about your plan? On each and every carrier card no matter what plan you have is an 800 customer service number that you can call and get answers to your medical and billing questions. And if you can’t get an answer there you always have our number. Call us we can help.