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Originally Posted by retiredguy123
I'm confused. If you have the individual Blue Cross plan, the catastrophic limit for out of pocket expenses is $5,000 per year, so you would never have any expenses that exceed that amount. If you have the family plan, then the catastrophic limit goes up to $10,000, but you could purchase 2 individual plans and limit the catastrophic to $5,000 each. Before signing up for Medicare Part B, it is worth the time to do the math and compare the cost for the Medicare premiums to the potential benefits you may receive during the year. In my case, the Medicare premiums would be about $3,300. So, the potential benefit of having Medicare is a maximum of $1,700, the difference between the Blue Cross catastrophic limit and the Medicare premium. However, this potential benefit is usually lowered by the out of pocket costs for drugs, which are part of Blue Cross, but not covered by Medicare. And, most people don't spend the catastrophic limit every year. Some people like that they have no copays with Medicare and Blue Cross, but they forget that it is costing them the Medicare premium that is due every month.
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Yes we have the family plan for the two of us. If you check the policy BC/BS Federal requires a 15% co-pay for tests like MRI, Xray, bloodwork, CAT Scan, out patient procedures (15% of the allowed amount), etc. These days many, many surgeries are outpatient that used to be in-patient and they only pay the allowed amount on these and the doctors most times will send you a bill for the rest which includes the anesthesia, tests and doctor's bills. Those have been putting me in the poor house for the last five years. Recently I spent 8 hours in the emergency room for food poisoning. My out of pocket for that was $777. It was the difference between the hospital bill and what the insurance paid. When I get medicare to go with my BC/BS Federal I am praying all that goes away. Not sure where these fall in the catastropic part because they don't really say in that article. I have to assume if they were considered catastrophic BC/BS would have stopped charging me for them long ago. When I did my taxes this year I had over $20,000 in medical. Some of that was premiums but the rest was not it was what I mentioned above as well as doctor co-pays. Might be worth a call to BC/BS.