[Tbear]

When researching information about my partial knee replacement, one piece of the puzzle I could not wrap my arms around was how much it might cost me personally.

I have the Villages United Health Care Advantage insurance policy and all I could find out was that I wouldn't have to pay more than the maximum $1900 which was my out-of-pocket deductible.

For the benefit of those following this thread, I can now share with you what the hospital and doctor sent to the insurance company, what they paid and what I paid.

The largest bill was from the hospital - $84,828 of which insurance allowed and paid $8,595. I was in the hospital technically for 1 day with an overnight stay as required by Medicare and I paid a hospital copay of $150.

My doctor billed $2,800 for the surgery of which insurance allowed and paid $1,196. I paid nothing.

There were also some smaller charges from labs and another physician which I think was the anesthesiologist who charged $475 and was paid $142. None of which I had to pay.

The home physical therapy I had ( 13 sessions at $90 /session ) was paid in full by insurance and nothing out of my pocket.

The physical therapy I am now taking externally charges $180 per session but insurance allows and pays only $35 per session. I also pay $15 copay per session.

So all in all, my out of pocket for this entire ordeal has been very little. Adding in some copays for pain meds and the rest of my PT ( which ends the end of May ) I will have paid about $350 out of my pocket.

Someone opened up a scary thread in this forum called Medicare to allow Balanced Billing.

Tom Price who is the new director of HHS ( Health and Human Services ) is a former physician and as a congressman has been trying to pass legislation that would allow doctors and hospitals to charge their patients the difference between what Medicare allows and what they submitted. He is now in a position with a Republican house and Senate to try push something like this thru.

It would be disastrous for seniors. I haven't seen any actual action yet by Price to do this since he took his new position.

Imagine if I had to pay the difference or even some percentage of the difference between $84,828 and $8,595! I couldn't have had this procedure done on my knee.

We seniors need to keep an eye on this one, no matter which political party we favor!