This mistake is downright humorous. Really. Today we received an EOB in the amount of $306.00, for lab work performed on 2/25/12, in anticipation of my annual physical (or "wellness exam," as it has been re-named). The EOB showed that Medicare had paid the entire $306.00 (apparently, without any adjustment). But here's the really funny part: I don't have Medicare. At least, not Part B. And Part A pays only toward hospitalization. I would imagine, therefore, that Medicare paid nothing at all toward the Submitted Charges. Needless to say, I immediately contacted Blue Cross/Blue Shield, by telephone, and asked them to re-process the claim. I also contacted the billing department of the doctors' medical group in question, and gave them a heads-up. And I asked that they delay re-submitting the claim for a couple of weeks, until I could have time to get this error fully corrected. (If Medicare really did pay that claim--which I simply cannot imagine--it would certainly shed some light on the matter of why the program is in such serious fiscal trouble...)
Quite possibly not a mistake. As of 2011, under the affordable health care act, Medicare recipients are covered for certain preventive care procedures. Here is a link to more of the details.
The problem is this: I am not a Medicare recipient. Not of Part B, anyway. And Part A covers hospitalization--but not doctors' services.
No. My wife and I have Blue Cross/Blue Shield of Tennessee. (Note: Medicare Advantage is what might be known as Part C; but one seldom hears that term anymore. Part D is prescription-drug coverage.)
Since the preventive care stuff is covered by Medicare for those over 65, BC/BS may be able to pass that cost over to Medicare. When I retire (in 4 years), I will keep BC/BS provided by my employer, but I have to sign up for Medicare which becomes my primary with the BC/BS as my secondary provider.
Who is your employer? And why do you have to sign up with Medicare? My wife (who retired from the VA in 1995) took her BC/BS healthcare insurance with her. But she does not have Medicare Part B. And neither do I. (We both have Part A--which pays toward hospitalization--as there is no extra cost with it, beyond what was paid in taxes during one's working lifetime.)
I work for a State related university and have the state employee insurance coverage through BC/BS of DE. When we turn 65 we go on Medicare with BC/BS as our secondary coverage (dependents keep full BC/BS until they turn 65). My employer continues to pay it's share and I wind up with full coverage with small co-pays and a small deductible.
You do desperately need a proper health service, don't you? Pity your masters won't let you have one!
Poor buggers. Maybe we should send them care packages. Ive got some 2nd hand catheters I arent using.
I have excellent coverage for my wife and myself. If we had to go into the individual market, prior to the ACA, neither of us would be insurable at any price that we could afford and still be able to have a roof over our head and food on the table.
Well, here's the latest update: I called the billing office of the doctors' medical group today, to see if BC/BS had actually paid the claim. (Oddly, the pertinent EOB did show a "Claim Paid On" date of 3/14/2012--the "paid" date is always listed well ahead of the actual payment--but this seems to contradict the misinformation contained elsewhere in the EOB.) The lady with whom I spoke said they had not received payment yet from BC/BS; and that, indeed, Medicare had not paid anything toward the Submitted Charges (as, certainly, it should not have done). However, she indicated that it is possible that BC/BS may have reacted oddly since they had not yet received my annual coordination-of-benefits update that is required by federal law (at least, for healthcare-insurance plans sponsored by FEHB). (BC/BS has since sent the requisite inquiry; and I filled out the information and returned it, about a week ago.) She suggested that I wait another two or three weeks, and then call back at the billing office.
Actually this now makes much more sense. The Co-ordination of benefits form can be a real issue. The plan I am on requires it as well, and if it's missing it can create all kinds of headache's.
I am on medicare part A but since I am still working I prefer to keep the Union BC/BS coverage. I pay nothing (except the $4.50 an hour that the Employer pays) so it would not be beifical to go on part B at this time.
Funny Io, I'll bet my insurance covers more things and I get faster service than you do. The only Master I have resides upstairs.
Well, yes. Sorta-kinda, anyway. But it still leaves unanswered the seminal question, viz.: Why has BC/BS attributed to me a health-insurance policy (i.e. Medicare Part B) that I simply do not have--and never have had?
That is very close to the situation that we are in (even though my wife and I are both retired now). There actually would be some advantages to our having Medicare Part B: e.g. there would no longer be any co-pays (except for prescription drugs) with in-network providers; there would no longer be any coinsurance with in-network providers; there would no longer be any deductibles with in-network providers; and a 90-day supply of generic drugs would cost only $10, instead of $15. Still, I have been eligible for Medicare since 2008; and my wife has been eligible since 1996. And considering the annual 10 percent penalty for late enrollment, it would now cost either of us exponentially more than the $115.40 baseline amount.
And there you go making fool statements again. By no means am I a millionaire but my insurance covers anything I need up to and over a million dollars. As I said, I'll bet I have better coverage than you and faster medical service. Any bets, hot rod??? And hotrod, I have 6 children, 25 grandchildren, and 8 great grandchildren, how many do you have??? And isn't it funny that I was able to take care of their medical needs while only making around $30,000 a year while my kids were at home?? And, YES, hotrod, I did have medical insurance through the Union I belonged to, just as I do now. Once I found out how much it helped I wouldn't work for a company that didn't offer it. And as I have told others, their probem is, for the most part it would seem, that they are TOOOOOOOOO educated. You see Io, I only have a 9th grade education. I quit school and went to work full time when I was 15 because I couldn't read. My young wife taught me to read the first year we were married. And, once more, before you get carried away with yourself, she was 18 (which by todays standards is young) and I was the ripe old age of 17. Now, back to people being toooooooo educated today to figure out what a high school drop out learned very early on in life. If the company doesn't offer medical insurance you find one that does even if it means taking a cut in pay. Any more smart remarks???
