IMPORTANT--New Medicare change in January 2011

Discussion in 'General Health & Wellness' started by TwoCatDoctors, Dec 29, 2010.

  1. TwoCatDoctors

    TwoCatDoctors New Member

    My neurologist today informed me of a new change to Medicare that very few of his patients know about. Starting January 2011, if a doctor injects you with any type of medication--you are responsible to pay not only the office visit charge/co-payment, but also you must pay 20 percent of that drug/medication you are injected with no matter what plan you are on.

    I am on a Medicare Advantage HMO plan and for a while have gotten occiptal neural blocks and all I have paid is the office visit co-pay. Starting January I will have to paythe office visit co-pay PLUS 20 percent of the cost of the injected drug/medication.

    SO MAKE SURE YOU CHECK THIS WITH YOUR DOCTOR BEFORE HE DOES INJECTION PROCEDURES AS SOME MEDS ARE VERY EXPENSIVE. I DON'T KNOW HOW IT WILL WORK FOR VACCINES AND IF THEY WILL BE FREE OR BE 20 PERCENT ALSO.
  2. TwoCatDoctors

    TwoCatDoctors New Member

    I spoke with my primary care doctor/general care doctor yesterday as to what the situation is with Medicare on payment of 20 percent of injected medication like Shingles Vaccine, Tetanus shots, flu shots, children's vaccines, etc. He said that definitely you do not have to pay the 20 percent on the Shingles vaccine or Tetanus shots as Medicare is picking up that --but said that he is unsure how it will go on flu shots or vaccines for children and that has to be resolved yet.

    He also said that many doctors are deciding to collect the co-pay/office visit and then later send a bill for the 20 percent Medicare charge instead of trying to figure it out in the office while the patient waits. My doctor also said that if the 20 percent comes to something like $5, then Medicare is not charging for it.

    So stay tuned as apparently this still has to be worked out and fine tuned as it goes along so all the doctors are on the same page.