The “IRMAA” Surcharge: How Your Retirement Withdrawal Can Accidentally Double Your Medicare Premium
The Tax Return That Cost Me Thousands
I was shocked when I saw my first Medicare Part B premium. It was double what my neighbor was paying. The reason? A high-income surcharge called IRMAA. Medicare sets your premium based on your tax return from two years ago. Two years ago, I was still working and had a high income. Even though I was retired now, I was being charged based on my old salary. It was a painful lesson: your income from your working years can come back to haunt your first few years of Medicare premiums.
How I Successfully Appealed My “IRMAA” Decision After a Life-Changing Event (Like Retirement)
The Form That Fixed My Premium
I was hit with a huge IRMAA surcharge on my Medicare premium because of my high income from two years prior. But I had just retired, and my income was now much lower. I learned I could appeal this decision. I filled out a form called SSA-44, the “Life-Changing Event” form. I provided proof of my retirement, like a letter from my old employer. This allowed Social Security to recalculate my premium based on my new, lower income. My premium was cut in half. It was a simple form that saved me thousands.
The Part B Deductible: The First Bill You’ll Get Every Year (And How to Plan for It)
The First Financial Hurdle of the Year
Every January, I know my first doctor’s visit of the year will come with a small bill. This is for the annual Medicare Part B deductible. It’s a small amount, usually a couple hundred dollars, that you have to pay out-of-pocket for your doctor’s services before your Medicare coverage kicks in at 80%. I just plan for it. I know that after I pay that one bill, for the rest of the year, my costs will be covered by Medicare and my Medigap plan. It’s the one and only deductible I have to worry about.
My Guide to the 20% Coinsurance on Part B That Can Lead to Unlimited Financial Risk
The 20% That Scared Me Straight
Original Medicare pays 80% of your doctor bills. You are responsible for the other 20%. I learned that this 20% “coinsurance” has no yearly limit. If you have a catastrophic, million-dollar medical event, your 20% share would be $200,000. That unlimited financial risk was the single biggest reason I chose to buy a Medigap plan. My Medigap plan pays that 20% for me. Now, I have a predictable monthly premium and I am shielded from the potentially unlimited costs of that 20% coinsurance.
The “Observation Stay” Trap: How a Hospital Stay Can Cost You Thousands (Because It Wasn’t an “Admission”)
The Two Words That Changed My Bill
I spent two nights in the hospital with chest pains. I thought I was “admitted.” But when I got the bill, I was shocked. The hospital had classified my stay as “under observation.” Because I wasn’t formally “admitted” as an inpatient, Medicare Part A didn’t cover it. It was all billed under Part B, leaving me with a huge 20% co-pay. I learned a hard lesson: always ask the doctor, “Am I being admitted as an inpatient, or am I here under observation?” Those two words can make a thousands-of-dollars difference.
My Story: My “Covered” Surgery Came with a Surprise $5,000 Anesthesiologist Bill.
The Doctor I Never Met, the Bill I Never Expected
My knee surgery was pre-approved and covered by my Medicare Advantage plan. I thought I was all set. Then, a month later, a surprise bill for $5,000 arrived from the anesthesiologist. I was confused. I learned that while the hospital and my surgeon were in my plan’s network, the anesthesiologist was not. It was a classic “surprise bill.” I had to fight it through my plan’s appeals process. It taught me to always ask before a surgery: “Is every single person in this room, including the anesthesiologist, in my network?”
The Unspoken Cost of “Excess Charges” and How a Medigap Plan Can Protect You
The Extra 15% That Some Doctors Can Charge
I learned about a strange rule in Medicare called “excess charges.” It means that a doctor who doesn’t “accept assignment” can legally bill you for up to 15% more than the Medicare-approved amount. This extra charge would come directly to me as a surprise bill. It felt like a hidden penalty for choosing the wrong doctor. My Medigap Plan G, however, completely covers these excess charges. It’s a key feature that gives me the freedom to see any doctor without having to worry about these unexpected, extra bills.
How to Budget for Your “Maximum Out-of-Pocket” on a Medicare Advantage Plan
The Number That Defines My Financial Worst-Case Scenario
I chose a Medicare Advantage plan with a $0 monthly premium. But I knew that didn’t mean my healthcare was free. The most important number in my plan is the “Maximum Out-of-Pocket” (MOOP), which is $6,700. In my annual budget, I have to be mentally and financially prepared for the possibility of spending that full amount in a bad health year. I think of my MOOP as my “real” deductible. I hope I never have to spend it, but I have to budget as if I will.
The “Skilled Nursing Facility” 3-Day Rule That Bankrupts People
The Rule That Cost My Neighbor His Life Savings
My neighbor fell and broke his hip. He spent two days in the hospital and was then moved to a skilled nursing facility for rehab. He was shocked when he got a bill for the entire rehab stay. Medicare refused to pay. The reason? The dreaded “three-day rule.” Medicare will only cover a skilled nursing stay if you have been formally “admitted” as an inpatient to a hospital for at least three consecutive days first. His two-day stay meant he was on the hook for the entire, bankrupting bill.
My Guide to Understanding Your “Medicare Summary Notice” (MSN) and Spotting Errors
The “Notice” That’s Not a Bill
Every three months, I get a “Medicare Summary Notice” (MSN) in the mail. The first time I got one, I thought it was a bill and I panicked. I learned it’s not a bill. It’s just a summary of all the services my doctors have billed to Medicare on my behalf. I now review it carefully. I check the dates and the services listed. Once, I saw a charge for a doctor’s visit on a day I was out of town. I reported the error to Medicare. The MSN is my tool for catching fraud and mistakes.
The Unspoken “Lifetime Reserve Days” for a Long Hospital Stay
The 60 Days I Hope I Never Have to Use
I learned that Medicare Part A covers my hospital stays, but not forever. After my first 90 days in the hospital in a benefit period, I have to start using my “lifetime reserve days.” I have a total of 60 of these days to use over my entire lifetime. They do not renew. If I ever have a truly catastrophic, long-term hospitalization, once those 60 days are gone, they are gone forever. It’s a crucial, and finite, safety net that I hope I never have to touch.
How My Physical Therapy Was “Capped” at an Arbitrary Limit
The Therapy I Needed, The Cap I Hit
I was recovering from a shoulder surgery and needed intensive physical therapy. After about two months of sessions, I was told that Medicare would no longer pay for it. I had hit the annual therapy “cap,” a dollar limit on what Medicare will pay for outpatient therapy. My therapist had to submit a special request for an exception, proving that the continued therapy was medically necessary for my recovery. It was a frustrating, arbitrary limit that almost halted my progress.
The Hidden Costs of Durable Medical Equipment (DME) Maintenance and Supplies
The Oxygen Tank Was Free, But the Tubing Wasn’t
Medicare covered the cost of my home oxygen concentrator. I was so relieved. But then I discovered the hidden costs. The machine itself was covered, but I was responsible for a 20% co-insurance on the monthly rental fee. I also had to pay out-of-pocket for some of the replacement supplies, like the disposable tubing and nasal cannulas. The “durable medical equipment” benefit is great, but it’s important to understand the ongoing costs for the rental and the supplies that come along with the main device.
My Story: The “Facility Fee” That Doubled the Cost of My Doctor’s Visit
The Same Doctor, the Same Room, a Much Bigger Bill
I had been seeing my cardiologist for years at his private office. Then, his practice was bought by the local hospital. The next time I went for a check-up, I was shocked. My bill had two charges: one from my doctor, and a new, separate “$200 facility fee” from the hospital. I was sitting in the same room with the same doctor, but because the office was now a “hospital-based outpatient department,” my cost had doubled. It’s a sneaky fee that is becoming more and more common.
The Guide to Understanding What “Accepting Assignment” Means (And Why It’s Crucial)
The Two Words That Protect My Wallet
Before I see any new doctor, I ask their office one crucial question: “Do you accept Medicare assignment?” If they say yes, it means they have agreed to accept the Medicare-approved amount as full payment for their service. They cannot legally bill me for more than the standard 20% co-insurance. If a doctor does not accept assignment, they can charge me an extra 15% “excess charge” on top of that. Only seeing doctors who “accept assignment” is a simple rule that saves me from surprise bills.
How to Avoid Surprise Bills from an “Out-of-Network” Lab or Radiologist
The Blood Draw That Came With a Surprise Bill
My primary doctor is in my Medicare Advantage plan’s network. I assumed that when she drew my blood in her office, everything was fine. But then I got a surprise bill from an out-of-network laboratory. My doctor’s office had sent my blood sample to a lab that they had a contract with, but that lab was not in my insurance plan’s network. I learned I have to ask not just if my doctor is in-network, but also, “Which lab and which radiology group do you use, and are they in my network, too?”
The Unspoken Cost of Mental Health Care (And Its Unequal Co-Pays)
The Therapy That Cost More Than a Specialist
I was on a Medicare Advantage plan and was happy with the low co-pays for my regular doctor visits. But when I needed to see a therapist for my anxiety, I was shocked. The co-pay for a mental health visit was double the co-pay for a visit to a medical specialist like a cardiologist. While the Mental Health Parity law has helped, many plans still have unequal cost-sharing for mental healthcare. It was a frustrating discovery that it cost me more to take care of my mind than my body.
My Guide to the “Lifetime Psychiatric Inpatient Day Limit”
The 190 Days That Have to Last a Lifetime
I learned that Medicare’s coverage for inpatient psychiatric care is different from its coverage for regular hospital care. While the coverage for a medical hospital stay can be very long, Medicare will only pay for a total of 190 days of inpatient care in a psychiatric hospital over your entire lifetime. It’s a hard, lifetime limit. This rule is a relic from a time when mental illness was treated very differently. It’s a crucial, and scary, limitation to be aware of if you or a loved one ever needs intensive, long-term psychiatric care.
How to Plan for Your Medigap “Premium Increases” as You Age
The Bill That Always Goes Up
When I first bought my Medigap plan at 65, the premium was very affordable. But I knew that was just the starting price. My plan’s premiums are “attained-age” rated, which means the price goes up every single year as I get older. When I am planning my retirement budget, I have to account for this. I assume that my Medigap premium will increase by about 3-5% every single year. Planning for these predictable, age-based increases helps me avoid a surprise budget crunch down the road.
The Unspoken “Foreign Travel Emergency” Costs That Medicare Won’t Touch
The Broken Arm in Paris That Cost Me a Fortune
I was on a dream trip to Paris when I fell and broke my arm. I was shocked and horrified to learn that with very few, rare exceptions, my Original Medicare plan provides absolutely no coverage outside of the United States. I had to pay for my French emergency room visit and doctor’s care completely out of my own pocket. It cost me thousands of dollars. It was a very expensive lesson: if you are traveling overseas, you absolutely must buy a separate travel health insurance policy. Medicare stops at the border.
My Guide to Understanding the Part A “Benefit Period” Deductible
The Deductible That Can Strike More Than Once a Year
I knew that Medicare Part B had a small annual deductible. I was confused by the Part A deductible for a hospital stay. It’s not an annual deductible; it’s based on a “benefit period.” A benefit period starts the day you are admitted to the hospital and ends when you have been out for 60 consecutive days. If I go into the hospital in January, I pay the deductible. If I go home and then have to be re-admitted in April, I pay that same deductible again because a new benefit period has started.
How an Ambulance Ride Can Cost You More Than a Plane Ticket
The Ride I Didn’t Choose, The Bill I Didn’t Expect
I had to take an ambulance to the hospital after a fall. I was grateful for the help. Then I got the bill. The 10-mile ride cost over $1,500. I was shocked. I learned that while Medicare Part B does cover ambulance services, you are still responsible for the 20% co-insurance. And since the base rates for ambulance rides are so high, that 20% can be a huge, unexpected bill. My Medigap plan covered that co-insurance, but for someone on Original Medicare alone, it can be a major financial hit.
The Unspoken Cost of “Non-Covered” Services Your Doctor Might Order
The Test My Doctor Wanted, But Medicare Wouldn’t Pay For
My doctor recommended a specific, new type of blood test as part of my annual physical. He said it was a good preventative screening. But when I got the bill, I saw that Medicare had denied the claim. I was on the hook for the full cost. I learned that just because my doctor orders a test doesn’t mean Medicare will pay for it. Medicare only covers services that it has deemed “medically reasonable and necessary.” My doctor’s preventative test was considered “investigational,” and I had to pay.
My Story: I Got a Bill from a Collection Agency for a “Covered” Service.
The Ghost of a Bill I Thought Was Paid
I thought my Medicare and Medigap plan had paid for my entire surgery. A year later, I got a letter from a collection agency for a $500 lab bill related to the surgery. I was confused and angry. I called the lab’s billing office. It turned out they had submitted the claim with a typo in my Medicare ID number. The claim was denied, and they just sent it to collections instead of fixing it. I gave them my correct information, they re-billed Medicare, and the collection disappeared.
The Guide to Using an HSA from a Previous Life to Pay for Medicare Costs
The Old Account That Funded My New Healthcare
Before I retired, I had a Health Savings Account (HSA) from my high-deductible plan at work. I had a nice balance saved up. I learned that while I can no longer contribute to my HSA now that I’m on Medicare, I can absolutely use the money that’s already in there, tax-free, to pay for my Medicare expenses. I now use my HSA debit card to pay my monthly Part B and Part D premiums. It’s a wonderful way to use my old, tax-advantaged savings to pay for my current healthcare costs.
How to Pay Your “Part B” Premium (And What Happens if You Don’t)
The Bill That Comes Straight From My Social Security
Most people, including me, have their monthly Medicare Part B premium automatically deducted from their Social Security check. It’s easy; I never even see a bill. But my friend who delayed taking Social Security gets a paper bill from Medicare every quarter. She has to remember to pay it. I learned that if you fail to pay your Part B premium, you will be sent a warning, and if you still don’t pay, you can be disenrolled from Medicare completely. It’s the one bill you absolutely cannot ignore.
The Unspoken Cost of “Custodial” Long-Term Care (That Medicare Doesn’t Cover)
The Care My Mom Needed, The Bill Medicare Denied
My mother needed help with daily activities like bathing, dressing, and eating. This is called “custodial care.” We were shocked to learn that Medicare does not pay for this type of long-term care at all, whether it’s at home or in a nursing home. Medicare only covers short-term “skilled” medical care after a hospitalization. The huge, ongoing cost of my mother’s custodial care was something we had to cover out-of-pocket until she could qualify for Medicaid. It’s the biggest, most misunderstood gap in Medicare’s coverage.
My Guide to Using a “Medicare Savings Program” (MSP) to Cover Your Costs
The State Program That Pays My Medicare Bills
I am on Medicare, but I have a very low, fixed income. The monthly Part B premium and the co-pays were a huge burden. A social worker told me about the Medicare Savings Programs. It’s a Medicaid-run program for low-income seniors. I applied through my state’s Medicaid office. I was approved for the “QMB” program. Now, the state pays my entire Medicare Part B premium for me. It also covers all my Medicare co-pays and deductibles. It’s an essential program that makes Medicare truly affordable for those who need it most.
How to Budget for the “Donut Hole” in Your Part D Plan
The Gap in My Coverage That I Plan For
I know that every year, around August, I will fall into the Part D “donut hole,” and my prescription costs will go up for a few months. I budget for this. I know that during those months, I will be paying 25% of the cost of my brand-name drugs. I look up the retail price of my medications and calculate what that 25% will be. I make sure to have extra money saved up to cover those higher costs in the fall. By anticipating and planning for the donut hole, it’s no longer a scary surprise.
The Unspoken “Administrative” Fees Some Doctors Charge
The “New Patient” Fee That Was a Surprise
I went to a new primary care doctor for my “Welcome to Medicare” visit. I was shocked when I got a bill from the doctor’s office for a “$50 new patient administrative fee.” I called them, confused. They said it was a fee to cover the cost of setting up my chart. I knew this was not a Medicare-covered service. It was a private fee the office was charging. I argued that this fee was not disclosed to me beforehand. They eventually waived it, but it taught me to always ask a new doctor if they have any of their own, private office fees.
My Guide to the Costs Associated with “Chronic Care Management”
The Co-Pay for Coordinated Care
My doctor enrolled me in a “Chronic Care Management” program to help me manage my multiple health conditions. It’s a great service. A nurse from the office calls me once a month to check in and coordinate my care. I learned that Medicare considers this a separate Part B service. This means that every month, I am responsible for a small 20% co-insurance payment for that management service. It’s not a lot of money, but it was an unexpected monthly cost that I had to budget for.
How to Find Out the “Medicare-Approved Amount” for a Procedure Before You Get It
The Price I Looked Up Before I Went In
My doctor recommended a specific knee injection. Before I got it, I wanted to know what it would cost me. I asked my doctor’s office for the exact CPT code for the procedure. Then, I went to the “Physician Fee Schedule Look-Up Tool” on the Medicare website. I typed in the code, and the tool showed me the exact “Medicare-approved amount” for that injection. I knew my responsibility would be 20% of that number. This tool allowed me to know my out-of-pocket cost before I ever walked into the doctor’s office.
The Unspoken Cost of “Convenience” in Healthcare
The Urgent Care That Was Really an ER
I had a bad cough and went to what I thought was an urgent care clinic. It was conveniently located in a strip mall. The bill, however, was a nightmare. It turned out it was a “freestanding emergency room,” and they billed my Medicare as if I had been to a full-blown hospital ER. My 20% co-insurance was huge. I learned that convenience has a cost. Now, I always verify if a clinic is a true “urgent care” or a more expensive “freestanding ER” before I walk in the door.
My Story: How a “Simple” Outpatient Procedure Turned into a Financial Nightmare
The Surgery I Had in the Morning, the Bills That Followed for a Year
I had a “simple” outpatient cataract surgery. I went in, had the surgery, and was home by the afternoon. I thought the cost would be simple, too. I was wrong. I got a bill from the surgeon. I got a separate bill from the surgery center for the “facility fee.” I got a third bill from the anesthesiologist. Then, I got a bill for the prescription eye drops. It was a financial nightmare. It taught me that even a “simple” outpatient procedure can create a complex and costly web of different bills from different providers.
The Guide to Using a “Medical Bill Advocate” to Fight Your Bills
The Expert I Hired to Slay My Financial Dragons
I was drowning in a sea of confusing Medicare bills and notices. I was out of my depth and overwhelmed. I made the decision to hire a professional “medical bill advocate.” She charged an hourly fee. She took my mountain of paperwork, organized it, and went to battle for me. She found billing errors, appealed denials, and negotiated with providers. She ended up saving me over ten times what I paid her in fees. Sometimes, when the fight is too big, you need to hire a professional dragon slayer.
How to Handle the Cost of Prescriptions Filled During a Hospital Stay
The Pills That Weren’t Part of the Room Rate
I was in the hospital for a week. I assumed all the pills the nurse gave me were just part of my Part A hospital coverage. I was surprised to learn it’s more complicated. Most of the medications I received were covered under my Part A stay. But my doctor also prescribed a few “self-administered” drugs that Medicare considers to be Part D drugs, even in the hospital. The hospital actually billed my Part D plan for those specific medications. It was a confusing quirk of the billing system that I never would have expected.
The Unspoken Power of Asking “What is My Out-of-Pocket Cost for This?”
The Question That Cuts Through the Confusion
My doctor recommended a new type of imaging scan. Instead of just saying “okay,” I learned to ask the most important question in healthcare: “What will my estimated out-of-pocket cost be for this?” This simple question forces the doctor’s billing office to do the work for me. They had to check my insurance, look up the allowable amount, and give me a real-dollar estimate of my financial responsibility. Asking this one question every single time has saved me from countless surprise bills and has made me an empowered, informed consumer.
My Guide to Understanding the Different “Cost-Sharing” Models (Co-pay vs. Co-insurance)
The Flat Fee vs. The Percentage
I learned that there are two main ways I share the cost of my healthcare. A “co-pay” is a flat, predictable dollar amount, like the $25 I pay to see my primary doctor on my Medicare Advantage plan. “Co-insurance” is a percentage of the total bill. My Original Medicare has a 20% co-insurance for doctor visits. This is less predictable. A small bill means a small co-insurance, but a huge bill means a huge co-insurance. Understanding the difference between these two models is key to understanding your financial risk.
The Unspoken Cost of “Delayed Care”: How Waiting Makes Things More Expensive
The Toothache I Ignored Became a Root Canal
I had a small toothache, but I was worried about the dental co-pay on my Medicare Advantage plan, so I ignored it. I waited for months. By the time the pain was unbearable, the simple cavity had turned into a massive infection that required an expensive root canal and a crown. The cost of the complex procedure was ten times what the simple filling would have been. I learned a hard lesson: delaying care because of a small, initial cost can often lead to a much more complex and expensive medical problem down the road.
How to Create an “Annual Medicare Budget” That Actually Works
The Budget That Gave Me Peace of Mind
To get control of my retirement finances, I created an annual Medicare budget. I listed my fixed costs first: my Part B premium and my Medigap premium. I knew those would be the same every month. Then I added my estimated variable costs: my Part D deductible at the beginning of the year, and my monthly prescription co-pays. Finally, I added a small “contingency fund” for any unexpected costs. Having this clear, one-page budget helps me track my spending and gives me a sense of control over my healthcare finances.
The Guide to “Tax Deductions” for Your Medicare Premiums and Medical Expenses
The Silver Lining on My Tax Bill
I was surprised to learn from my accountant that I could deduct some of my Medicare costs on my federal tax return. My Medicare Part B premiums, my Medigap premiums, and my Part D premiums are all considered medical expenses. If my total medical spending for the year exceeds a certain percentage of my adjusted gross income (7.5%), I can deduct the amount above that threshold. It doesn’t save me a huge amount, but it’s a nice silver lining that helps to lower my overall tax burden.
The Unspoken Financial Risk of Choosing the Wrong Enrollment Path at 65
The Decision That Can’t Be Undone
At 65, I chose a Medicare Advantage plan because the premium was zero. Five years later, I developed a chronic illness and wanted the freedom of a Medigap plan. I was shocked to learn I couldn’t get one. Because I was past my initial open enrollment, insurance companies could now deny me a policy because of my pre-existing condition. I was trapped in my Advantage plan. Choosing the wrong path at 65, I learned, can have permanent financial consequences. It’s a decision that is very difficult to reverse.
My Story: How I Set Up an “Auto-Pay” System for My Premiums and Never Worried Again
The “Set It and Forget It” Solution to My Bills
I had three separate monthly premiums for my Medicare coverage: one for my Part B, one for my Medigap plan, and one for my Part D plan. I was always worried I would forget to pay one of them. I decided to “set it and forget it.” I set up my Part B premium to be automatically deducted from my Social Security check. I then went online and set up my Medigap and Part D premiums to be automatically charged to my credit card each month. Now, all my premiums are paid automatically, and I never have to worry about missing a payment.
The Guide to Understanding How Your “Dual Eligible” Status Eliminates Costs
The Two Cards That Erased All My Bills
I am a “dual eligible,” which means I have both Medicare and Medicaid. It’s the ultimate financial protection. Medicare is my primary insurance and pays first. Then, my state Medicaid program acts as my secondary insurance. It pays for all the costs that Medicare leaves behind. It covers my Part B premium. It covers my Part A and B deductibles. It covers my 20% co-insurance. The end result is that my total out-of-pocket cost for all my Medicare-covered services is zero. It’s a complete and total safety net.
The #1 Hidden Cost That Surprises New Medicare Beneficiaries
The Bill for the Pills
The number one hidden cost that surprises almost all my friends when they get on Medicare is prescription drugs. They are so relieved that Medicare Part A and B cover their doctors and hospitals, they don’t realize that Original Medicare covers almost no outpatient prescription drugs. You must enroll in a separate Part D plan to get coverage for your medications. Forgetting to do this, or not understanding the high co-pays on some plans, is the biggest and most common financial shock for new beneficiaries.
How to Financially Prepare for a “Worst-Case Scenario” Health Year
My “Rainy Day” Fund for My Health
I have a great Medicare Advantage plan, but I know that in a “worst-case scenario” year, I could be on the hook for up to $7,500 in out-of-pocket costs. I’m not rich, but I have a financial plan for this. I have a separate, dedicated savings account that I call my “Maximum Out-of-Pocket Fund.” Every month, I put a small amount of money into it. My goal is to have my full MOOP amount saved up. It’s my personal rainy day fund, and it gives me peace of mind knowing I’m prepared for a storm.
The Unspoken Peace of Mind of Having a Predictable Cost Structure
The Comfort of Knowing
The reason I chose to pay a higher monthly premium for a Medigap plan was for the peace of mind. I know that for the rest of my life, my healthcare costs will be predictable. I have my monthly premiums, and that’s it. I will never get a surprise bill for thousands of dollars after a hospital stay. I will never have to worry about a huge co-pay for chemotherapy. That predictability, that freedom from financial anxiety, is a benefit that is worth more to me than any free gym membership.
My Guide to “Shopping Around” for Non-Emergency Procedures
The MRI I Got for Half the Price
My doctor told me I needed a non-emergency MRI. The hospital where he has privileges wanted to charge an astronomical amount. I knew I had a choice. I called my insurance plan and asked for a list of other in-network imaging centers in my area. I then called two of those centers and asked for their “cash price” for the MRI. I found a reputable, high-quality center that charged less than half of what the hospital wanted. By shopping around for a non-emergency procedure, I was able to save myself, and Medicare, thousands of dollars.
The Unspoken Cost of “Bad Advice” from an Unqualified Agent
The “Friend of a Friend” Who Cost Me a Fortune
When I turned 65, a “friend of a friend” who sold insurance told me I didn’t need to worry about signing up for Part B because I had COBRA. That advice was dead wrong. Because I followed it, I missed my enrollment window and was hit with a lifelong late enrollment penalty. The cost of that bad advice will be thousands of dollars over my lifetime. The lesson is to only ever take Medicare advice from a certified, unbiased SHIP counselor or a truly independent broker who specializes in Medicare. Bad advice is the most expensive thing of all.
The Ultimate “No Surprises” Guide to Medicare Costs
My Personal Rules for Financial Peace
I have a simple set of rules to ensure I never get a surprise Medicare bill. First, I always ask a new doctor if they “accept assignment.” Second, before any surgery, I ask if every single person in the room is in my network. Third, before any test or procedure, I ask for the CPT code and look up the cost myself. And fourth, I review my Medicare Summary Notice every three months to check for errors. These four simple habits have given me a “no surprises” life when it comes to my healthcare costs.