tdiu Question Re: Fee For Non-S/c Surgery ...

[hollywoodnc]

I am at present, awaiting a decision for a proximately related S/C for a RT Hip.

I am being told by EVERY doctor, that I require a THR. The problem is, that I cannot afford to pay surgical fees, hospital & medication, co pays, etc..

I DO have Medicare....no Medicaid.

The questions:

Do Veterans with a 30% (LT Hip) and 20% (Lumbar), have to pay for non service connected (RT) hip surgery?

What is/are the fee(s) based on? Income? Total disability rating? Other?

I am also pending a TDIU.

A CUE claim retro 1976.

Recently, I was informed that I have a worn polyethylene hip socket cup, thereby requiring surgery for my Lt. S/C hip..AGAIN!

Boy...when it rains, it pours!

Life SUCKS...I'm falling apart!

[diver]

Me too I am also falling apart. I don't know exactly how the billing works. I wish I did for you. What I do know is the billing is based off of income and other insurance. But that is all I know. I hope someone else can answer your question a lot better for you.

[Philip Rogers]

Sounds like you need a Medicare Supplement but chose not to make the purchase. I carry both Medicare A&B, plus a supplement and a drug plan. I use the annual COLA's to pay for them, as it allows me the freedom to use private physicians/hospitals, when needed. I still get my meds from the VA but on occasion, when I need them now, I can get them locally and then have the follow-up prescriptions issued by the VA.

As to costs - Medicare will pay most of the hospital bill if you go to a private hospital. They also have reduced price services that you may qualify for. The VA won't bill Medicare. I have no idea what the co-payment would be at a VAMC. You might check w/them, to find out. jmo

pr

[Stretch]

PR is right on the money.

I pay for supplemental with medicare and everything is paid. Think the supplemental cost 100 per month. The supplemental is humana. In this way you do not have to wait for SC.

Edited January 13, 2015 by Stretch

[rpowell01]

Sounds like you need a Medicare Supplement but chose not to make the purchase. I carry both Medicare A&B, plus a supplement and a drug plan. I use the annual COLA's to pay for them, as it allows me the freedom to use private physicians/hospitals, when needed. I still get my meds from the VA but on occasion, when I need them now, I can get them locally and then have the follow-up prescriptions issued by the VA.

As to costs - Medicare will pay most of the hospital bill if you go to a private hospital. They also have reduced price services that you may qualify for. The VA won't bill Medicare. I have no idea what the co-payment would be at a VAMC. You might check w/them, to find out. jmo

pr

BE careful because those medicare supplements will sometimes cost more than regular insurance. I have medicare and looked into a supplement and the average monthly fee was between $400 and $500 a month. Noway jose can I even afford that even getting 1005 compensation and on SSDI. I have a family of 5 (including myself) and its very, very hard. Even though you have medicare these insurance companies charge us folks who are under the age of 50 too much and supplement insurance should not be allowed to charge this much based on age.