Imagine a plan where you only pay 20% of the cost of healthcare. Sounds like a deal, right? Buyer beware!
Not all services are covered by the Advantage copay. Many outpatient
services require the patient to pay 20% of the approved cost of care. Here is a partial list of things where you may be required to pay 20% . . .
Chemotherapy
Radiation therapy
Infusion therapy
Part B medications
Ambulance, including air ambulance
Outpatient surgery including cataracts
Dialysis
PT (physical therapy)
SNF (skilled nursing facility) and rehab services following a hospital stay
Memory care for Alzheimer’s and dementia patients
DME (durable medical equipment) including walker,
wheelchair, hospital bed, CPAP, oxygen, home infusion services, nebulizer and medication for nebulizer, etc.
You are responsible for your 20% share UP TO the plan maximum, typically $5,000 to $8,500 for PPO plans . . . could be up to $12,000 in some cases.
Ouch!