Perna, Thanx for your reply! Much appreciated. I wanted to clarify a couple of things. Not sure how it affects your feelings on this.

Like many Medigap policies, my policy only pays on what is covered by Medicare. It pays deductibles and copays, nothing else.

My doctors just require that, if there's no secondary policy, you pay the copay at time of service. I've never heard of a doctor's office refusing care if someone doesn't have secondary insurance, though there are some specialists I haven't seen. Probably would need the money up front for non-emergency surgery. I have done insurance billing (years ago), but it was at pediatric clinics, where there tends to be less restrictions on seeing patients who owe money. For outpatient services, the local healthcare conglomerate asks for a partial payment up front. I asked about an MRI and was told that I would need to pay $50. They have on their website the income levels that they use to determine how much of your bill will be written off. I would not have to pay much, if any at all. In the past, I've had hospital bills written off. Not sure how the ACA affects this, but in the past, hospitals that received federal funds were required to provide a certain amount of charity care. The woman who does the Medicare insurance counseling said that this hospital wouldn't write off the bill from her husband's final admission. They have worked with her and she pays $5/month.

Sorry this is so long.