Medicare

L

Landy

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>JazzysMom</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>want2Banony</b></i>



Not always true....My Medicare is primary and my private ins. is secondary.</end quote></div>



I dont know your cirmcustances, but unless something has changed since I worked in a hospital billing office Medicare is secondary. I am referring to the primary being a group health plan tho. Maybe that is where the difference is?</end quote></div>

What if you have Medicare, then get added to your spouse's insurance....would Medicare then switch to secondary coverage?
 
J

JazzysMom

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Lynda</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>JazzysMom</b></i>



<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>want2Banony</b></i>



Not always true....My Medicare is primary and my private ins. is secondary.</end quote></div>




I dont know your cirmcustances, but unless something has changed since I worked in a hospital billing office Medicare is secondary. I am referring to the primary being a group health plan tho. Maybe that is where the difference is?</end quote></div>



What if you have Medicare, then get added to your spouse's insurance....would Medicare then switch to secondary coverage?</end quote></div>

Yes Lynda. As long as the person who the insurance is thru is still employed (not retired). Medicare use to have a questionnaire (when I worked so dont know if it still exists) that would need to be completed annually so they could update their records regarding coverage. I have had many, many, many, MANY claims denied because Medicare is billed as Primary. I think much of this comes from those handling the claims &/or entering the info not understanding. Its a real PITA, but what are you going to do!
 
J

JazzysMom

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Lynda</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>JazzysMom</b></i>



<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>want2Banony</b></i>



Not always true....My Medicare is primary and my private ins. is secondary.</end quote></div>




I dont know your cirmcustances, but unless something has changed since I worked in a hospital billing office Medicare is secondary. I am referring to the primary being a group health plan tho. Maybe that is where the difference is?</end quote></div>



What if you have Medicare, then get added to your spouse's insurance....would Medicare then switch to secondary coverage?</end quote></div>

Yes Lynda. As long as the person who the insurance is thru is still employed (not retired). Medicare use to have a questionnaire (when I worked so dont know if it still exists) that would need to be completed annually so they could update their records regarding coverage. I have had many, many, many, MANY claims denied because Medicare is billed as Primary. I think much of this comes from those handling the claims &/or entering the info not understanding. Its a real PITA, but what are you going to do!
 
J

JazzysMom

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Lynda</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>JazzysMom</b></i>



<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>want2Banony</b></i>



Not always true....My Medicare is primary and my private ins. is secondary.</end quote></div>




I dont know your cirmcustances, but unless something has changed since I worked in a hospital billing office Medicare is secondary. I am referring to the primary being a group health plan tho. Maybe that is where the difference is?</end quote></div>



What if you have Medicare, then get added to your spouse's insurance....would Medicare then switch to secondary coverage?</end quote></div>

Yes Lynda. As long as the person who the insurance is thru is still employed (not retired). Medicare use to have a questionnaire (when I worked so dont know if it still exists) that would need to be completed annually so they could update their records regarding coverage. I have had many, many, many, MANY claims denied because Medicare is billed as Primary. I think much of this comes from those handling the claims &/or entering the info not understanding. Its a real PITA, but what are you going to do!
 
L

Landy

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Giggles</b></i>

Anybody know how Medicare works when it is Secondary?
Thanks
Jennifer 35 Years old with CF and CFRD</end quote></div>


I have Medicare as secondary & after meeting the deductible, it covers the remaining amount due for my inhaled medications and diabetes supplies. It also covers any co-pays at the Dr's office. It's very rare that I have to pay anything from doctor's appointments.

I'm not sure about hospitilizations, but would assume it picks up the remainder of what your primary insurance doesn't cover.
 
L

Landy

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Giggles</b></i>

Anybody know how Medicare works when it is Secondary?
Thanks
Jennifer 35 Years old with CF and CFRD</end quote></div>


I have Medicare as secondary & after meeting the deductible, it covers the remaining amount due for my inhaled medications and diabetes supplies. It also covers any co-pays at the Dr's office. It's very rare that I have to pay anything from doctor's appointments.

I'm not sure about hospitilizations, but would assume it picks up the remainder of what your primary insurance doesn't cover.
 
L

Landy

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Giggles</b></i>

Anybody know how Medicare works when it is Secondary?
Thanks
Jennifer 35 Years old with CF and CFRD</end quote></div>


I have Medicare as secondary & after meeting the deductible, it covers the remaining amount due for my inhaled medications and diabetes supplies. It also covers any co-pays at the Dr's office. It's very rare that I have to pay anything from doctor's appointments.

I'm not sure about hospitilizations, but would assume it picks up the remainder of what your primary insurance doesn't cover.
 
J

JazzysMom

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Lynda</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Giggles</b></i>



Anybody know how Medicare works when it is Secondary?

Thanks

Jennifer 35 Years old with CF and CFRD</end quote></div>


I have Medicare as secondary & after meeting the deductible, it covers the remaining amount due for my inhaled medications and also covers any co-pays at the Dr's office. It's very rare that I have to pay anything from doctor's appointments.



I'm not sure about hospitilizations, but would assume it picks up the remainder of what your primary insurance doesn't cover.</end quote></div>

Lynda....are you sure it is co pays that medicare is covering and not co insurance. In my medicare booklet that we all get....its specifically says it does not cover co pays of a primary insurance, but will cover 80% of co insurance from the primary. Of course that is after meeting the medicare deductable. As far as inpatient coverage.....whether its primary or secondary you still have an inpatient deductable that would be due each admit IF you are inpatient free for 60 days or more between the admissions.
 
J

JazzysMom

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Lynda</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Giggles</b></i>



Anybody know how Medicare works when it is Secondary?

Thanks

Jennifer 35 Years old with CF and CFRD</end quote></div>


I have Medicare as secondary & after meeting the deductible, it covers the remaining amount due for my inhaled medications and also covers any co-pays at the Dr's office. It's very rare that I have to pay anything from doctor's appointments.



I'm not sure about hospitilizations, but would assume it picks up the remainder of what your primary insurance doesn't cover.</end quote></div>

Lynda....are you sure it is co pays that medicare is covering and not co insurance. In my medicare booklet that we all get....its specifically says it does not cover co pays of a primary insurance, but will cover 80% of co insurance from the primary. Of course that is after meeting the medicare deductable. As far as inpatient coverage.....whether its primary or secondary you still have an inpatient deductable that would be due each admit IF you are inpatient free for 60 days or more between the admissions.
 
J

JazzysMom

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Lynda</b></i>

<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>Giggles</b></i>



Anybody know how Medicare works when it is Secondary?

Thanks

Jennifer 35 Years old with CF and CFRD</end quote></div>


I have Medicare as secondary & after meeting the deductible, it covers the remaining amount due for my inhaled medications and also covers any co-pays at the Dr's office. It's very rare that I have to pay anything from doctor's appointments.



I'm not sure about hospitilizations, but would assume it picks up the remainder of what your primary insurance doesn't cover.</end quote></div>

Lynda....are you sure it is co pays that medicare is covering and not co insurance. In my medicare booklet that we all get....its specifically says it does not cover co pays of a primary insurance, but will cover 80% of co insurance from the primary. Of course that is after meeting the medicare deductable. As far as inpatient coverage.....whether its primary or secondary you still have an inpatient deductable that would be due each admit IF you are inpatient free for 60 days or more between the admissions.
 
L

Landy

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>JazzysMom</b></i>

Lynda....are you sure it is co pays that medicare is covering and not co insurance. In my medicare booklet that we all get....its specifically says it does not cover co pays of a primary insurance, but will cover 80% of co insurance from the primary. Of course that is after meeting the medicare deductable. As far as inpatient coverage.....whether its primary or secondary you still have an inpatient deductable that would be due each admit IF you are inpatient free for 60 days or more between the admissions.</end quote></div>

All I know is that w/ my primary insurance, we have co-pays with each doctor's visit. They range from $20-$40, depending on what type of doctor, and I never have to pay those because Medicare pays them. I don't know the whole "why or how" they pay, I just know that they do.
You mean that we're supposed to read those books they send out yearly?<img src="i/expressions/face-icon-small-wink.gif" border="0"> lol
 
L

Landy

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>JazzysMom</b></i>

Lynda....are you sure it is co pays that medicare is covering and not co insurance. In my medicare booklet that we all get....its specifically says it does not cover co pays of a primary insurance, but will cover 80% of co insurance from the primary. Of course that is after meeting the medicare deductable. As far as inpatient coverage.....whether its primary or secondary you still have an inpatient deductable that would be due each admit IF you are inpatient free for 60 days or more between the admissions.</end quote></div>

All I know is that w/ my primary insurance, we have co-pays with each doctor's visit. They range from $20-$40, depending on what type of doctor, and I never have to pay those because Medicare pays them. I don't know the whole "why or how" they pay, I just know that they do.
You mean that we're supposed to read those books they send out yearly?<img src="i/expressions/face-icon-small-wink.gif" border="0"> lol
 
L

Landy

New member
<div class="FTQUOTE"><begin quote><i>Originally posted by: <b>JazzysMom</b></i>

Lynda....are you sure it is co pays that medicare is covering and not co insurance. In my medicare booklet that we all get....its specifically says it does not cover co pays of a primary insurance, but will cover 80% of co insurance from the primary. Of course that is after meeting the medicare deductable. As far as inpatient coverage.....whether its primary or secondary you still have an inpatient deductable that would be due each admit IF you are inpatient free for 60 days or more between the admissions.</end quote></div>

All I know is that w/ my primary insurance, we have co-pays with each doctor's visit. They range from $20-$40, depending on what type of doctor, and I never have to pay those because Medicare pays them. I don't know the whole "why or how" they pay, I just know that they do.
You mean that we're supposed to read those books they send out yearly?<img src="i/expressions/face-icon-small-wink.gif" border="0"> lol
 
J

JazzysMom

New member
Here is a link to a more detailed, but yet easy to follow explanation on how Medicare works with other insurance coverage. Hope it helps.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf">http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf</a>
 
J

JazzysMom

New member
Here is a link to a more detailed, but yet easy to follow explanation on how Medicare works with other insurance coverage. Hope it helps.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf">http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf</a>
 
J

JazzysMom

New member
Here is a link to a more detailed, but yet easy to follow explanation on how Medicare works with other insurance coverage. Hope it helps.

<a target=_blank class=ftalternatingbarlinklarge href="http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf">http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf</a>
 
W

want2Banony

New member
I am an adult with CF. I went on long term disability through my job, and also got SSDI. After 2 years I got medicare. I can keep my LTD until I am 65 which includes keeping my group health insurance. My medicare is primary and my group health is secondary. I am CERTAIN of this as I've had it this way for several years. I was told if the group health (private ins.) was through my spouse/spouse's job then it would be primary and medicare would be secondary. But since it is through ME and MY job, it is the other way---medicare primary. I even called and asked to be sure and both medicare and private told me this was correct. Perhaps it makes a difference what state you live in?
 
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