topic Re: Medicare and Supplemental Insurance Question in Wellness

Medicare and Supplemental Insurance Question

Winkk — Mon, 05 Jan 2015 18:05:08 GMT

I have a question for those who use Medicare and supplemental insurance. My sister started Medicare this month and she chose to go with a supplemental insurance plan. She hasn't really kept herself too involved with the process (she's using a broker to help her) but she said when she goes to the doctors she just gives them her Medicare card. Do you know if that is correct? Doesn't she also have to supply them with her supplemental insurance card?

I am on an Advantage Plan so I'm not familiar with the process, I just use one card.

Thanks.

Re: Medicare and Supplemental Insurance Question

Havarti — Mon, 05 Jan 2015 18:09:24 GMT

I am on Blue Cross Senior Gold and I need to present that card only. I do not need to present the Medicare card because BC manages that - they get whatever payment they are entitled to directly from Medicare and they pay the rest of covered items. Hope that helps.

Re: Medicare and Supplemental Insurance Question

Thrive — Mon, 05 Jan 2015 18:13:52 GMT

I am on Blue Cross Blue shield through retirement with my employer. I retired as a result of disability. Therefore, I went to Medicare automatically after a couple of years. I now present my Medicare card and my Blue Cross Supplemental card. I am sure that Medicare will answer your specific question by phone or email.

Re: Medicare and Supplemental Insurance Question

namaste000 — Mon, 05 Jan 2015 18:15:25 GMT

When you go to a doctor you need to show your medicare card and the supplemental card. Usually, once they copy them and put both in their records, you will not have to show anything at future visits with that doctor. They will just ask if you have any changes in your healthcare. Any new doctor will ask for both cards.

That said, it is safer to have the 2 cards with you at office visits, just in case they want to see them.

The bill from your doctor visit goes thru Medcare first and then they route it to your supplement plan.

Re: Medicare and Supplemental Insurance Question

scotnovel — Mon, 05 Jan 2015 18:17:08 GMT

Did she tell the doctor's office she also has a supplemental plan? If not they may not have asked her for her supplemental card. Or it may depend on what the office is willing to file.

After doing some research recently to change my primary physician (I'll be 65 this year), I found some that, while they would file with medicare, they would not accept or file certain other medigap (supplemental) plans. If I had chosen one of those doctors, I assume I would have had to file the supplemental claims myself after medicare paid their share.

Re: Medicare and Supplemental Insurance Question

Lavenderjunkie — Mon, 05 Jan 2015 18:17:40 GMT

As I understand it, when you sign up for the medigap supplement that insurance company is supposed to inform medicare and then medicare automatically forwards the claims to the insurance company after medicare has done their thing. That is how it's supposed to work. I think it's called coordination of benefits.

However, I always show both cards when going to a doctors office. First of all, it can take several months for the medicare/insurance company coordination to be set up. You need for the doctors office to know you have the supplement insurance so they won't bill you after the medicare payments have been received and they know to wait for the insurance company payments to come in too. And if they don't get paid by the insurance co, they know the details on which insurance company to contact. Or if they bill you you can direct them to the insurance co and they have the info on file. This is important at the start of the year, but also though out the year. In addition, different supplement plans may have different terms with regard to copays, deductibles, etc.

Hope this helps.

Advantage plans work totally differently and not all doctors who accept medicare accept advantage plans.

Re: Medicare and Supplemental Insurance Question

jjeanne — Mon, 05 Jan 2015 18:18:26 GMT

I am on a medicare advantage program which I love!!!!!!!!!!!!!! I always shoe both insurance cards. I always recommend a medicare advantage program, if they have to go out of the program to get you the right help, they do. No questions asked. Good luck.

Re: Medicare and Supplemental Insurance Question

Winkk — Mon, 05 Jan 2015 18:23:27 GMT

Thanks everyone. I thought she at least needed to show her supplemental insurance card but she said she hasn't received one yet. She assumed that information was just forwarded to Medicare and she didn't have to be concerned about it.

I appreciate your responses.

Re: Medicare and Supplemental Insurance Question

Tinkrbl44 — Mon, 05 Jan 2015 18:49:16 GMT

Whenever you have ANY type of health insurance/ Medicare coverage, you need to show the relevant cards, at least for the first time.

Many doctors' offices will record the information and use that for future visits. It's up to the patient to notify them of any future changes.

I don't know why she would think she can get coverage .... and then not provide the information!

Re: Medicare and Supplemental Insurance Question

Tyak — Mon, 05 Jan 2015 18:58:58 GMT

I have to always show my medicare card and my supplemental ins. card.

Re: Medicare and Supplemental Insurance Question

Winkk — Mon, 05 Jan 2015 18:59:08 GMT

On 1/5/2015 Tinkrbl44 said:
Whenever you have ANY type of health insurance/ Medicare coverage, you need to show the relevant cards, at least for the first time.

Many doctors' offices will record the information and use that for future visits. It's up to the patient to notify them of any future changes.

I don't know why she would think she can get coverage .... and then not provide the information!

I know. She doesn't seem to be grasping the Medicare concept. I told her how does the doctor know that you have supplemental insurance if you don't tell them. She said that when she signed up for supplemental she thought that insurance company would notify Medicare. My advantage plan is so much easier.

Re: Medicare and Supplemental Insurance Question

Tinkrbl44 — Mon, 05 Jan 2015 19:07:05 GMT

On 1/5/2015 Wink said:
On 1/5/2015 Tinkrbl44 said:
Whenever you have ANY type of health insurance/ Medicare coverage, you need to show the relevant cards, at least for the first time.

Many doctors' offices will record the information and use that for future visits. It's up to the patient to notify them of any future changes.

I don't know why she would think she can get coverage .... and then not provide the information!

I know. She doesn't seem to be grasping the Medicare concept. I told her how does the doctor know that you have supplemental insurance if you don't tell them. She said that when she signed up for supplemental she thought that insurance company would notify Medicare. My advantage plan is so much easier.

The supplemental insurance company might tell Medicare, but SHE needs to tell the physician's office ..... tell her it's just like health insurance ... you need to PROVE you have it!

Re: Medicare and Supplemental Insurance Question

millieshops — Mon, 05 Jan 2015 19:13:40 GMT

My experience has been that I need both cards, but that could be because all the doctors I use are in my gap policies preferred provider plan. The benefits are then co-ordinated and I get statements so that I know what, if any, extra dollars I'm liable for.

I'm 8 years into Medicare now and have been fortunate not to have had to go outside my plan to find good doctors and hospitals, but I always ask when I call any new office whether they accept my plan and even when I make an appointment with a doctor I've used before but not recently, I ask if they still accept my plan. For me, it's financially beneficial to stay within the plan as long as the doctor /hospital is good.

I've always assumed that if a doctor would not accept my plan, the staff would not need that card.

Re: Medicare and Supplemental Insurance Question

orphan annie325 — Mon, 05 Jan 2015 19:27:34 GMT

You should always present all insurance cards when going to the Doctor's office. After the first claim goes through Medicare, you should be setup for automatic crossover filing from Medicare to your supplemental insurance. If not, contact Medicare to provide your supplemental information.

With regard to the comment about your physician not accepting medicare supplement insurance, as long as they accept Medicare, you can use your supplement insurance. The only difference comes with a Medicare Advantage plan since you need to use a network physician. Med Sup plans do not work with a network.

I am providing this info based on 22 years working with AARP medicare supplement insurance co and it is what I carry now that I am retired.

Re: Medicare and Supplemental Insurance Question

Winkk — Mon, 05 Jan 2015 20:07:18 GMT

Thanks everyone for your responses.

Re: Medicare and Supplemental Insurance Question

151949 — Mon, 05 Jan 2015 22:02:33 GMT

On 1/5/2015 millieshops said:
My experience has been that I need both cards, but that could be because all the doctors I use are in my gap policies preferred provider plan. The benefits are then co-ordinated and I get statements so that I know what, if any, extra dollars I'm liable for.

I'm 8 years into Medicare now and have been fortunate not to have had to go outside my plan to find good doctors and hospitals, but I always ask when I call any new office whether they accept my plan and even when I make an appointment with a doctor I've used before but not recently, I ask if they still accept my plan. For me, it's financially beneficial to stay within the plan as long as the doctor /hospital is good.

I've always assumed that if a doctor would not accept my plan, the staff would not need that card.

I was not aware that a medicare supplement plan could be an HMO or PPO type plan. I was under the impression they had to cover any doctor/provider that takes medicare. Medicare advantage plans are typically HMO/PPO plans but when you have those you do not use your medicare card at all bec ause you are covered fully by the advantage plan and medicare does not pay anything.

Re: Medicare and Supplemental Insurance Question

kittymomNC — Mon, 05 Jan 2015 22:25:44 GMT

I have my supplemental plan with United Health Care, and they state that supplemental plans allow you to go to any doctor or hospital in the United States that accepts Medicare. When I go to a new doctor, they always make a copy of my Medicare Card and my Supplemental Card, and then I don't have to show them again. However, if anything did happen to change, I would need to notify them.

I've been on regular Medicare with a Supplemental policy since I started, and I've never had to pay a penny out of pocket for any doctors, overnight hospital stay, tests, etc. I only pay my premiums. I get a statement from Medicare periodically telling me what has been filed and the status of each claim... it also states whether or not it has been filed with my supplemental company. To my knowledge, Medicare forwards the claim to United Health Care after they have made their payments. United Health Care then makes their payments directly to the doctors/hospital, and I get a periodic statement from them as well.

Re: Medicare and Supplemental Insurance Question

kittymomNC — Mon, 05 Jan 2015 22:31:26 GMT

On 1/5/2015 Wink said:
On 1/5/2015 Tinkrbl44 said:
Whenever you have ANY type of health insurance/ Medicare coverage, you need to show the relevant cards, at least for the first time.

Many doctors' offices will record the information and use that for future visits. It's up to the patient to notify them of any future changes.

I don't know why she would think she can get coverage .... and then not provide the information!

I know. She doesn't seem to be grasping the Medicare concept. I told her how does the doctor know that you have supplemental insurance if you don't tell them. She said that when she signed up for supplemental she thought that insurance company would notify Medicare. My advantage plan is so much easier.

It's really no different than your Advantage plan as far as notifying the doctors. When you go to a new doctor, you would have to give them the information for your Advantage plan. When she goes to a new doctor, she just needs to give them both cards (Medicare and supplemental) - two cards instead of one. If they make a copy like my doctors' offices do, she doesn't have to do anything else. The doctor's office files with Medicare, and then Medicare files with her supplemental. She will receive periodic EOB's from Medicare showing what claims have been filed, the status, and whether they've been filed with her supplemental. The supplemental company should also send her a periodic EOB.

Re: Medicare and Supplemental Insurance Question

cascol — Mon, 05 Jan 2015 23:42:52 GMT

Whenever you go to a doctor for the first time, always show them whatever coverage cards you have. Some doctors will ask to see them again or ask you if there has been any change at the beginning of the new year. Some people switch plans. Always let them know if there are any changes.

Re: Medicare and Supplemental Insurance Question

RinaRina — Mon, 05 Jan 2015 23:45:12 GMT

On 1/5/2015 woodstockillinois said:
I am on a medicare advantage program which I love!!!!!!!!!!!!!! I always shoe both insurance cards. I always recommend a medicare advantage program, if they have to go out of the program to get you the right help, they do. No questions asked. Good luck.

Is that supplemental insurance? Sorry, I'm just learning this stuff. I'm not 65 yet.

Thanks.