Tag Archives: Medicare

How Medicare Handles Second Medical Opinions

Does Medicare cover second medical opinions? The doctor I currently see thinks I need back surgery, but I would like to find out more about other treatment options before I proceed. What can you tell me?

Medicare does pay for second opinions if your current doctor has recommended surgery or some other major diagnostic or therapeutic procedure. Getting a second medical opinion from another doctor is a smart idea. A second opinion may offer you a fresh perspective and additional options for treating your back condition so you can make a more informed decision. Or, if the second doctor agrees with your current doctor’s opinion, it can give you some reassurance moving forward.

If you are enrolled in original Medicare, 80% of the costs for second medical opinions are covered under Part B (you or your Medicare supplemental policy are responsible for the other 20%), and you do not need to obtain an order or referral from your doctor to see another doctor for a second opinion. Medicare will even pay 80% of the costs for a third medical opinion, if the first two differ. Most Medicare Advantage plans cover second opinions too, but you may need to follow certain steps to obtain coverage. For example, some plans will only help pay for a second opinion if you receive a referral from your primary care doctor. Plans also may require you to see doctors in their networks only. If you have a Medicare Advantage plan, you’ll need to call to find your plan’s rules.
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CMS to Simplify Medicare Plan Selection

The CMS is taking steps to make it easier to sort through Medicare coverage options, after a report said its current search options were badly presented and confusing and could lead some to make poor plan selections. Continue reading

Role Reversal: Discussing Estate Planning with Aging Parents

The parent-child relationship is pretty well defined. Children generally don’t advise their parents. It’s the other way around. However, this dynamic can shift as parents get older and children become adults. This becomes especially prevalent when considering estate planning and elder law issues. Continue reading

Nursing Home Costs Rise Sharply in 2017

Elderlawanswers.com reports that the median cost of a private nursing home room in the United States has increased to $97,455.00 a year, up 5.5% from 2016, according to Genworth 2017 cost of care survey, which can be found at www.genworth.com/aboutus/industry-expertise/cost/of-care.html which the insurer conducts annually.  Genworth reports that the median cost of a semi-private room in a nursing home is $85,775.00, up 4.44% from 2016.  The rising prices is much larger than the 1.24% and 2.27% gains, respectively in 2016. Continue reading

Medicare: Closing the “Donut Hole”

The government has made a commitment to close the “donut hole” gap in Medicare coverage by 2020, but many current beneficiaries still find themselves falling into this pricey crevasse. Continue reading