Bart and Grace are long-time clients and were enjoying their retirement. Hiking, biking, and some travel. It was what they had envisioned their lives would be after retiring. On a bright and early Monday morning we received a call from Bart, who was in a panic!

Grace had fallen ill, and they immediately scheduled an appointment with her Primary Care Physician, whom they had known for years. Some tests were run, and her doctor’s worst fears were confirmed. Grace needed immediate surgery. After verifying that the surgeon was in their Medicare Advantage network, as well as the hospital, Grace was admitted, and the surgery scheduled.

After the surgery was completed, Bart was relieved that everything went extremely well, and Grace would be able to go home soon. But as the surgeon was making the rounds that afternoon, he gave Bart some additional news he wasn’t expecting. While Grace didn’t need to be in the hospital, she was not quite well enough to go home. Her doctor was recommending that she be transferred to a skilled nursing facility for a few days. Then if she was doing well, she could go home. While disappointed, Bart knew that this was in his wife’s best interest, but he was starting to worry about what this was all going to cost.

On his way out of the hospital, he stopped by the business office and requested a copy of the bill to date. He was handed the printout and Bart folded it and stuck it in his pocket and took it home. Later that evening, while sitting at his kitchen table, he started reviewing the bill and was shocked that the bill was already almost $80,000. And this amount didn’t include the additional costs for the skilled nursing facility. At this point…… he called us.

After we reviewed the Medicare Advantage plan that they were both on, we were happy to report that he didn’t need to worry about the $80,000 bill. On their plan, they have no deductible, and the hospital co-pay was only $200 a day. The skilled nursing facility was also going to be at no cost for the first 20 days. So, their entire out-of-pocket expenses would be less than $1,000 in co-pays. She was in the hospital for 4 days, at $200 a day, for a total hospital co-pay of $800, and the skilled nursing facility was at no cost since she was only there for 4 days before she could go home.

Bart was incredibly relieved to be reminded of their co-pays. Now that he didn’t have to worry about the medical bills, he could focus on helping Grace get the care she needed. We originally assisted them in selecting their Medicare Advantage plan several years ago, and he was thankful he could call us for clarification of the coverage.

If you are not sure about how your plan works? Give us a call we can help!