Medicare co pays - Page 4

Carmie · ‎10-25-2010

@software I believe you. Many times the secondary insurance will not cover expenses if Medicare denies it. If that is your benefit, that would happen.

For other,people, their secondary insurance will cover expenses denied by Medicare. That is their benefit.

Secondary Insurance pays differently depending on your plan.

Medicare supplemental insurance will never cover claims denied by Medicare.

It can be complicated.

Still Raining · ‎03-30-2014

I assume you have not been required to participate in Part B, so your claim appears to be covered under Part A. In that case I believe the only things used for the MSP amount are your Part A deductible and coinsurance amount status.. The primary copay is not a factor. Check the EOB and call the office. You can find the CFR sections on the Medicare site.

Carmie · ‎10-25-2010

@Still Raining wrote:
I assume you have not been required to participate in Part B, so your claim appears to be covered under Part A. In that case I believe the only things used for the MSP amount are your Part A deductible and coinsurance amount status.. The primary copay is not a factor. Check the EOB and call the office. You can find the CFR sections on the Medicare site.

Medicare Part A is for inpatient facility (hospital/nursing home) charges only.

If you do not have Part B of Medicare, you do not have Medicare coverage for any outpatient services, either at a doctor office or a facility.

software · ‎06-08-2016

@Carmie wrote:
@software I believe you. Many times the secondary insurance will not cover expenses if Medicare denies it. If that is your benefit, that would happen.

For other,people, their secondary insurance will cover expenses denied by Medicare. That is their benefit.

Secondary Insurance pays differently depending on your plan.

Medicare supplemental insurance will never cover claims denied by Medicare.

It can be complicated.

I only bring it up because everyone with an insurance experience, thinks theirs it gospel, when we all have a responsibility to understand how it all works. Each situation can be different. I'm sure you have stories to tell after all your experience!!

ahoymate · ‎05-30-2010

Why not call Medicare or secondary insurance, MD's office, call the experts? We can't decipher your situation. Call the people who have your plans.

Carmie · ‎10-25-2010

@software wrote:
@Carmie wrote:
@software I believe you. Many times the secondary insurance will not cover expenses if Medicare denies it. If that is your benefit, that would happen.

For other,people, their secondary insurance will cover expenses denied by Medicare. That is their benefit.

Secondary Insurance pays differently depending on your plan.

Medicare supplemental insurance will never cover claims denied by Medicare.

It can be complicated.

I only bring it up because everyone with an insurance experience, thinks theirs it gospel, when we all have a responsibility to understand how it all works. Each situation can be different. I'm sure you have stories to tell after all your experience!!

Thanks, I have heard some of the best stories on here. It is amazing that so many people give advice that is very incorrect. If I dont know the correct answer, I will just say I don't know and refer the poster to someone I think can help them if I can.

I love the responses who say to call an expert. There are no experts. I have already called the CSR's at Medicare because they gave incorrect information to my family members. The reps who answer the phones actually work for a health insurance company and not the Federal Government. I used to answer those Medicare calls. The health insurance company I worked for had a Medicare contract and we processed Medicare claims.

I am not faulting anyone. It is so very complicated. It took me at least five years on the job to be comfortable with the information. What is also awful is that if wrong info was given out, no one was responsible. The poor caller is at the mercy of the CSR.

I just hope and pray it doesn't get any worse.

gabstoomuch · ‎03-16-2010

I wish there was a way to save threads on here. I learn so much, and people talk in plain English, in an understandable way.

There was another really good Medicare thread a long time ago, probably over a year ago that had all sorts of good info on it. They keep changing the boards so these informational threads get lost.

So in reference to this thread, is it better to not even offer up the medicare card if you have regular insurance?

My ex-husband, who still insures me, is turning 65 in 2 months and I am getting inundated with medicare info and I don't understand any of it. He is still employed and intends to stay that way as far as I know. But he has to sign up for Medicare when he turns 65. Now I have no idea what happens. Do we even have to say we have Medicare?

Carmie · ‎10-25-2010

@gabstoomuch there are some questions your x needs to ask his employer's HR dept.

He needs to find out if Medicare will be primary, or if his employers insurance will be primary.

If his employers insurance is primary, he must sign up for Medicare Part A when he is 65, but might not need Medicare B until he loses his employers insurance.

If Medicare is primary, he will need Parts A and B.

he also needs to see if his employer offers a supplement to Medicare or if his group's insurance is a secondary insurance policy, if medicare is primary.

He should talk to his employer ASAP, especially if he will be 65 In two months. Don't delay.

Once you find out more info, don't hesitate to contact me for more information or help if you need it.