Medicare as secondary payer

[JazzysMom]

I dont have personal experience with Medicare & the Part D as I didnt sign up for it since I have my husbands insurance.

I do know that my Mom gets her inhaled meds for her COPD through Part B. As Lynda pointed out tho.....COPD is the diagnosis so I dont know if she would have an issue otherwise.

As far as the doctors co pays....I still get mixed info on this. I had my neurologist charge me the 20% of my co pay & he will for the other 80%. I never got a bill for the difference....however, I have had to pay the full copay otherwise.

When I spoke with a rep at Medicare.....they told me that copays are not covered yet co insurance is. So I looked it up in my Medicare Manual & that is what it says. So for doctors that are in network where I only am only responsible for a copay....Medicare wont help, but with places like my CF Center where they are out of network & my responsibility will be co insurance then Medicare will pay 80% of that after I have reached my out patient Medicare deductable.

I hope this helps some. The prescription plan I really have no idea about....Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[JazzysMom]

I dont have personal experience with Medicare & the Part D as I didnt sign up for it since I have my husbands insurance.

I do know that my Mom gets her inhaled meds for her COPD through Part B. As Lynda pointed out tho.....COPD is the diagnosis so I dont know if she would have an issue otherwise.

As far as the doctors co pays....I still get mixed info on this. I had my neurologist charge me the 20% of my co pay & he will for the other 80%. I never got a bill for the difference....however, I have had to pay the full copay otherwise.

When I spoke with a rep at Medicare.....they told me that copays are not covered yet co insurance is. So I looked it up in my Medicare Manual & that is what it says. So for doctors that are in network where I only am only responsible for a copay....Medicare wont help, but with places like my CF Center where they are out of network & my responsibility will be co insurance then Medicare will pay 80% of that after I have reached my out patient Medicare deductable.

I hope this helps some. The prescription plan I really have no idea about....Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[JazzysMom]

I dont have personal experience with Medicare & the Part D as I didnt sign up for it since I have my husbands insurance.

I do know that my Mom gets her inhaled meds for her COPD through Part B. As Lynda pointed out tho.....COPD is the diagnosis so I dont know if she would have an issue otherwise.

As far as the doctors co pays....I still get mixed info on this. I had my neurologist charge me the 20% of my co pay & he will for the other 80%. I never got a bill for the difference....however, I have had to pay the full copay otherwise.

When I spoke with a rep at Medicare.....they told me that copays are not covered yet co insurance is. So I looked it up in my Medicare Manual & that is what it says. So for doctors that are in network where I only am only responsible for a copay....Medicare wont help, but with places like my CF Center where they are out of network & my responsibility will be co insurance then Medicare will pay 80% of that after I have reached my out patient Medicare deductable.

I hope this helps some. The prescription plan I really have no idea about....Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[JazzysMom]

I dont have personal experience with Medicare & the Part D as I didnt sign up for it since I have my husbands insurance.

I do know that my Mom gets her inhaled meds for her COPD through Part B. As Lynda pointed out tho.....COPD is the diagnosis so I dont know if she would have an issue otherwise.

As far as the doctors co pays....I still get mixed info on this. I had my neurologist charge me the 20% of my co pay & he will for the other 80%. I never got a bill for the difference....however, I have had to pay the full copay otherwise.

When I spoke with a rep at Medicare.....they told me that copays are not covered yet co insurance is. So I looked it up in my Medicare Manual & that is what it says. So for doctors that are in network where I only am only responsible for a copay....Medicare wont help, but with places like my CF Center where they are out of network & my responsibility will be co insurance then Medicare will pay 80% of that after I have reached my out patient Medicare deductable.

I hope this helps some. The prescription plan I really have no idea about....Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[JazzysMom]

I dont have personal experience with Medicare & the Part D as I didnt sign up for it since I have my husbands insurance.
<br />
<br />I do know that my Mom gets her inhaled meds for her COPD through Part B. As Lynda pointed out tho.....COPD is the diagnosis so I dont know if she would have an issue otherwise.
<br />
<br />As far as the doctors co pays....I still get mixed info on this. I had my neurologist charge me the 20% of my co pay & he will for the other 80%. I never got a bill for the difference....however, I have had to pay the full copay otherwise.
<br />
<br />When I spoke with a rep at Medicare.....they told me that copays are not covered yet co insurance is. So I looked it up in my Medicare Manual & that is what it says. So for doctors that are in network where I only am only responsible for a copay....Medicare wont help, but with places like my CF Center where they are out of network & my responsibility will be co insurance then Medicare will pay 80% of that after I have reached my out patient Medicare deductable.
<br />
<br />I hope this helps some. The prescription plan I really have no idea about....Sorry <img src="i/expressions/face-icon-small-sad.gif" border="0">

 

[Skye]

THANK YOU for your responses!!

I am so confused by all of this....this is ridiculous. I can't believe we have a system like this. I have a master's degree and this makes no sense to me. I feel sorry for the seniors out there trying to figure this out. I don't understand why some on here have co-pays paid for and others are not getting that, ughh!

I am interested to know if any of you who carry Medicare as secondary have also gotten a medigap or other policy. From what I have been able to find out, you CAN NOT get a medigap or medicare advantage policy unless medicare is your primary. I just want to be sure of that before that opportunity passes for me.

I would like to know how SOME of us plan to retire under these Medicare circumstances. Yes, believe it or not....some CFers are going to be reaching retirement age. How are we going to survive in a system that requires a work-based policy for our survival. I guess my husband must work til he's 95!! It sounds like the Medicare Advantage and Medigap policies SUCK for prescription drugs. I hope something changes soon. Sorry for the rant.

 

[Skye]

THANK YOU for your responses!!

I am so confused by all of this....this is ridiculous. I can't believe we have a system like this. I have a master's degree and this makes no sense to me. I feel sorry for the seniors out there trying to figure this out. I don't understand why some on here have co-pays paid for and others are not getting that, ughh!

I am interested to know if any of you who carry Medicare as secondary have also gotten a medigap or other policy. From what I have been able to find out, you CAN NOT get a medigap or medicare advantage policy unless medicare is your primary. I just want to be sure of that before that opportunity passes for me.

I would like to know how SOME of us plan to retire under these Medicare circumstances. Yes, believe it or not....some CFers are going to be reaching retirement age. How are we going to survive in a system that requires a work-based policy for our survival. I guess my husband must work til he's 95!! It sounds like the Medicare Advantage and Medigap policies SUCK for prescription drugs. I hope something changes soon. Sorry for the rant.

 

[Skye]

THANK YOU for your responses!!

I am so confused by all of this....this is ridiculous. I can't believe we have a system like this. I have a master's degree and this makes no sense to me. I feel sorry for the seniors out there trying to figure this out. I don't understand why some on here have co-pays paid for and others are not getting that, ughh!

I am interested to know if any of you who carry Medicare as secondary have also gotten a medigap or other policy. From what I have been able to find out, you CAN NOT get a medigap or medicare advantage policy unless medicare is your primary. I just want to be sure of that before that opportunity passes for me.

I would like to know how SOME of us plan to retire under these Medicare circumstances. Yes, believe it or not....some CFers are going to be reaching retirement age. How are we going to survive in a system that requires a work-based policy for our survival. I guess my husband must work til he's 95!! It sounds like the Medicare Advantage and Medigap policies SUCK for prescription drugs. I hope something changes soon. Sorry for the rant.

 

[Skye]

THANK YOU for your responses!!

I am so confused by all of this....this is ridiculous. I can't believe we have a system like this. I have a master's degree and this makes no sense to me. I feel sorry for the seniors out there trying to figure this out. I don't understand why some on here have co-pays paid for and others are not getting that, ughh!

I am interested to know if any of you who carry Medicare as secondary have also gotten a medigap or other policy. From what I have been able to find out, you CAN NOT get a medigap or medicare advantage policy unless medicare is your primary. I just want to be sure of that before that opportunity passes for me.

I would like to know how SOME of us plan to retire under these Medicare circumstances. Yes, believe it or not....some CFers are going to be reaching retirement age. How are we going to survive in a system that requires a work-based policy for our survival. I guess my husband must work til he's 95!! It sounds like the Medicare Advantage and Medigap policies SUCK for prescription drugs. I hope something changes soon. Sorry for the rant.

 

[Skye]

THANK YOU for your responses!!
<br />
<br />I am so confused by all of this....this is ridiculous. I can't believe we have a system like this. I have a master's degree and this makes no sense to me. I feel sorry for the seniors out there trying to figure this out. I don't understand why some on here have co-pays paid for and others are not getting that, ughh!
<br />
<br />I am interested to know if any of you who carry Medicare as secondary have also gotten a medigap or other policy. From what I have been able to find out, you CAN NOT get a medigap or medicare advantage policy unless medicare is your primary. I just want to be sure of that before that opportunity passes for me.
<br />
<br />I would like to know how SOME of us plan to retire under these Medicare circumstances. Yes, believe it or not....some CFers are going to be reaching retirement age. How are we going to survive in a system that requires a work-based policy for our survival. I guess my husband must work til he's 95!! It sounds like the Medicare Advantage and Medigap policies SUCK for prescription drugs. I hope something changes soon. Sorry for the rant.

 

[Allisa35]

Skye, I'm still on the forum. I just don't post very often. I did go ahead and sign up for the Part B (so I do have A & B). I don't have the part D. I haven't been to the dr. since I have had Medicare. I go on the 23rd of this month so I guess I'll find out what happens. From what Melissa says, it sounds like I will still have to pay since it is a co-pay amount and not a co-insurance. It is still confusing to me as well and what's sad is that I used to be a Medicare billing clerk for a durable medical equipment company (years ago). I agree that it is a very flawed system. On the one hand, I am very thankful that I have that income coming in (from disability), and yet on the other hand, it makes me sick that I have to depend on the government for my income.

I also don't know anything about the Medigap policies. Hope you get some answers to your questions. I wasn't much help, but I haven't had anything billed yet.

 

[Allisa35]

Skye, I'm still on the forum. I just don't post very often. I did go ahead and sign up for the Part B (so I do have A & B). I don't have the part D. I haven't been to the dr. since I have had Medicare. I go on the 23rd of this month so I guess I'll find out what happens. From what Melissa says, it sounds like I will still have to pay since it is a co-pay amount and not a co-insurance. It is still confusing to me as well and what's sad is that I used to be a Medicare billing clerk for a durable medical equipment company (years ago). I agree that it is a very flawed system. On the one hand, I am very thankful that I have that income coming in (from disability), and yet on the other hand, it makes me sick that I have to depend on the government for my income.

I also don't know anything about the Medigap policies. Hope you get some answers to your questions. I wasn't much help, but I haven't had anything billed yet.

 

[Allisa35]

Skye, I'm still on the forum. I just don't post very often. I did go ahead and sign up for the Part B (so I do have A & B). I don't have the part D. I haven't been to the dr. since I have had Medicare. I go on the 23rd of this month so I guess I'll find out what happens. From what Melissa says, it sounds like I will still have to pay since it is a co-pay amount and not a co-insurance. It is still confusing to me as well and what's sad is that I used to be a Medicare billing clerk for a durable medical equipment company (years ago). I agree that it is a very flawed system. On the one hand, I am very thankful that I have that income coming in (from disability), and yet on the other hand, it makes me sick that I have to depend on the government for my income.

I also don't know anything about the Medigap policies. Hope you get some answers to your questions. I wasn't much help, but I haven't had anything billed yet.

 

[Allisa35]

Skye, I'm still on the forum. I just don't post very often. I did go ahead and sign up for the Part B (so I do have A & B). I don't have the part D. I haven't been to the dr. since I have had Medicare. I go on the 23rd of this month so I guess I'll find out what happens. From what Melissa says, it sounds like I will still have to pay since it is a co-pay amount and not a co-insurance. It is still confusing to me as well and what's sad is that I used to be a Medicare billing clerk for a durable medical equipment company (years ago). I agree that it is a very flawed system. On the one hand, I am very thankful that I have that income coming in (from disability), and yet on the other hand, it makes me sick that I have to depend on the government for my income.

I also don't know anything about the Medigap policies. Hope you get some answers to your questions. I wasn't much help, but I haven't had anything billed yet.

 

[Allisa35]

Skye, I'm still on the forum. I just don't post very often. I did go ahead and sign up for the Part B (so I do have A & B). I don't have the part D. I haven't been to the dr. since I have had Medicare. I go on the 23rd of this month so I guess I'll find out what happens. From what Melissa says, it sounds like I will still have to pay since it is a co-pay amount and not a co-insurance. It is still confusing to me as well and what's sad is that I used to be a Medicare billing clerk for a durable medical equipment company (years ago). I agree that it is a very flawed system. On the one hand, I am very thankful that I have that income coming in (from disability), and yet on the other hand, it makes me sick that I have to depend on the government for my income.
<br />
<br />I also don't know anything about the Medigap policies. Hope you get some answers to your questions. I wasn't much help, but I haven't had anything billed yet.

 

[Skye]

Thanks Allisa for responding<img src="i/expressions/face-icon-small-smile.gif" border="0"> I just have to say that I am shocked that you have not had anything billed yet<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> I must just be over the top with my doc visits etc. I think I had an insurance billing within days of my card becoming active<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> Well, let's just hope we can all figure this out as we go through the system.

 

[Skye]

Thanks Allisa for responding<img src="i/expressions/face-icon-small-smile.gif" border="0"> I just have to say that I am shocked that you have not had anything billed yet<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> I must just be over the top with my doc visits etc. I think I had an insurance billing within days of my card becoming active<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> Well, let's just hope we can all figure this out as we go through the system.

 

[Skye]

Thanks Allisa for responding<img src="i/expressions/face-icon-small-smile.gif" border="0"> I just have to say that I am shocked that you have not had anything billed yet<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> I must just be over the top with my doc visits etc. I think I had an insurance billing within days of my card becoming active<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> Well, let's just hope we can all figure this out as we go through the system.

 

[Skye]

Thanks Allisa for responding<img src="i/expressions/face-icon-small-smile.gif" border="0"> I just have to say that I am shocked that you have not had anything billed yet<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> I must just be over the top with my doc visits etc. I think I had an insurance billing within days of my card becoming active<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> Well, let's just hope we can all figure this out as we go through the system.

 

[Skye]

Thanks Allisa for responding<img src="i/expressions/face-icon-small-smile.gif" border="0"> I just have to say that I am shocked that you have not had anything billed yet<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> I must just be over the top with my doc visits etc. I think I had an insurance billing within days of my card becoming active<img src="i/expressions/face-icon-small-smile.gif" border="0"><img src="i/expressions/face-icon-small-smile.gif" border="0"> Well, let's just hope we can all figure this out as we go through the system.