I am still skeptical. Based on what I've had to pay over the years we are being nickle and dimed to death by the co-pays. My medicare can not be here soon enough. My husband has had it for 3 years now and he has yet to pay even a dime and he has had plenty of procedures. I don't think you are going to be able to convince me on this forum. I have to use my experience with all of this as a guide.

As in many decisions in life, sometimes you need to go with what allows you to sleep at night. I hope your decision brings you peace. Namaste.

I called my Federal BC/BS about the $777 hospital bill I received from last fall when I went to the emergency room. I was not admitted but received a pain shot and some fluids, a CAT scan, EKG and bloodwork. My co-pay is the amount above.

I asked her what the difference is in the standard option and the basic option of the federal plan. She said the biggest difference are the out of network services. With the standard plan they are covered but she said with the basic plan you might have a large out of pocket expense with non-covered doctors. She said the doctors drop out and go back in the plan often so it is very difficult to keep track of who is in and who is out of network. She said the doctors may be practicing in a preferred plan hospital but are non-participators. I don't know if this would be a problem at all for those who have medicare in addition to their BC/BS federal plan.

Have you discussed your situation with SHINE? Also BCBS? I’ve never heard that doctors go in and out of the plan frequently. I, for one, have never had a doctor who did this; but that’s just me. I’d do some research on this statement before taking it at face value.

I may have missed it but were any of the doctors who treated you during this recent visit out of network?

Not on this visit but on a previous visit to a surgery center last year I received a bill from an anesthesiologist who was out of network and the surgery center was in network. The customer service representative is the one who told me the doctors at the hospital go in and out of plans and that it is hard to keep track. I can't prove this, I just am quoting what she told me.

Thank you for your posts. I think your experiences give us a lot to think about. It’s unfortunate that we need to verify who’s in and out of network, especially at a time when we’re sick or hurt and the doctor’s current status is the last thing on our minds.

No one can say you should buy this one or that one because all of our situations are different. Some people can afford to be riskier when it comes to insurance because they have large bank accounts to fall back on. Some people do not.

Going with BC/BS BASIC along with Medicare Parts A and B is
not risky...its smart especially with the $600 return of medicare premiums (per person) they offer.

Can you please refresh my memory on what is part A and what is part B?

Part A is for in-patient hospital charges and has no annual premium. Part B is for doctor visits, surgery charges, lab testing, and out-patient care, but it does not cover any prescription drugs. The Blue Cross catastrophic limit applies to all types of copays and coinsurance. I can understand your skepticism about the Blue Cross catastrophic limit. But, I know first hand that it works. I had a close friend who had cancer for 3 years. She had massive medical bills and reached her catastrophic limit within the first few months of the year for 3 years. After spending $5,000 in copays and coinsurance, Blue Cross paid everything for the remainder of the year. That is the way it works, and I am depending on it and don't see any reason not to because it is a contractual agreement with Blue Cross. I don't plan to pay $3,300 in Medicare B premiums while Blue Cross offers a $5,000 catastrophic limit. It just doesn't make financial sense to me.

I have the Federal BC/BS Basic plan and I have to admit that I know nothing of the "catastrophic limit. I guess it does not pertain to me. When an operation costs over $20K and you pay $150 co-payment, I will be satisfied with that. And we did not have Medicare at the time, either. The Federal plan premiums are about one third for me and the rest is paid for by the government. I have no intention of paying a couple of grand a year for Medicare B when I do not need it and never will. That kind of redundancy is not for those that live on a limited fixed income.