Once again, the hospital is threatening to sue me over an unpaid bill. Since I have Medicare Part A, Medicare Part B, Medicare Supplemental Part F, and Medicare Drug Part D, I assumed that the bill was a mistake. After all, the supplemental policies are supposed to cover the portions of bills not covered by Part A and Part B. So I decided to make some phone calls about the bill, which I thought would be paid by insurance.
WRONG, there is a gotcha that most people don't know. So I learned something today after calling all of my insurance companies. Those pills brought to you by the nurse are considered "SELF ADMINISTERED MEDICATIONS" because they were not administered through an IV or injection, and none of the four different policies cover the outrageous charges for them. During three days in the hospital, I incurred $180.12 in non-covered charges just taking the medications I am normally prescribed.
Even the nitroglycerine I was given in the ER was not covered. My nitro is in a little metal vial attached to my cell phone, and I carry it with me at all times. I certainly could have taken my own nitro tablets for much less than the $10 per pill I now owe the hospital.
As a survivor of several surgeries, including coronary bypass, sometimes I have to make trips to the ER. Sometimes I have to be admitted. In addition to the standard Medicare coverage, I pay for the three supplemental insurance plans every month. Supposedly, this is FULL COVERAGE with no copays or deductibles.
The CATCH 22 is that no hospital will let you bring your own daily medications to the hospital. In other words, you cannot self administer the self administered medications. You have to let the hospital staff bring those medications to you and then Medicare disallows payment. None of the various insurance supplemental plans will pay for something disallowed by Medicare, and that includes the drug coverage plan. It is a hole in coverage that does not recognize the way things really work on the consumer end.
Every time a nurse brings you that little plastic cup of pills, you will be paying HOSPITAL prices out of your pocket for every pill if you are on Medicare. Medicare did allow $34,324.57 in charges, a huge portion of which Medicare negotiated away. With nobody to negotiate prices of daily meds for the patient, Medicare insureds must pay the full amount of whatever the hospital decides to charge.