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Originally Posted by petiteone
We get our retirement Medicare Advantage PPO through my husband's employer BLueCrossBlueShield. Co-pays are $15, we meet out deductible early in the year so drug costs are low. It covers Emergencies/Hospitalizations at The Villages Hospital, but The Villages Health Care System won't take it for PCPs.
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True story. My mother spent the last 4 months of her life in the hospital or in one of 5 different nursing homes for rehab. She had original Medicare and a supplement, so no copays. We often saw a female doctor who would show up no matter where my mother was and asked how she was doing. The doctor had never been hired by us, but we originally assumed that she worked for the hospital. The doctor never prescribed any medication and did not give any detailed medical advice. Apparently, she made the rounds every day to all of the hospitals and nursing homes in the area, visiting multiple patients at each location. When my mother died, I went through the Medicare statements and found out that this doctor was paid about $80 every day for an office visit to my mother for about 120 consecutive days. I don’t think the doctor would have been able to do that with a Medicare advantage plan because of the copays. This may sound like Medicare fraud, but, as long as the doctor actually saw my mother every day, I think the charges would be valid. I don’t know how she got my mother’s SS number, but she probably just asked my mother for it.