I understand when Medicare is primary and when Medicare is secondary. What is the difference in coverage between a Medicare Supplement and Medicare as a secondary insurer?
If you have a Medicare Supplement then the provider will bill Original Medicare first. At that time Medicare will pay the allowable amount and then return an explanation of benefits stating the beneficiary's portion. Based on the Medicare Supplement Plan that is in place (A-N) the Medicare Supplement will pay a portion or all of the remaining amount due. If they pay only a portion based on the plan (A-N), then according the plan guidelines, the beneficiary would pay any outstanding amount at that time.
If a Medicare beneficiary is covered on a employer or retiree group plan and due to the size of the plan, the group plan is primary, then the group plan benefits will apply first and any amounts due by the Beneficiary will be billed to Medicare second. If it is a Medicare covered service, then Medicare will pay the remaining amount due as the secondary payor up to the amount allowed by Medicare. If the service is not allowed by Medicare, than the beneficiary's co-insurance or co-payment under the group plan would be their responsibility.
You will bill medicare as primary and the supplement secondary. Usually if filing a HCFA 1500 electronically if the supplemental policy is on the beneficiaries Common Working File with Medicare it will automatically crossover to the supplemental policy. Hope this helps....
Please explain your question more thoroughly if my answer does not suffice. I am unsure of what you mean by Medicare Carve Out Coverage. You can buy a Medicare Supplement at any time once you have received your Medicare Part A and Part B. If you do not enroll within 6 months of your Part B effective date you would be subject to underwriting. You can not join a Medicare Supplement if you already have… Read More
If a provider accepts Medicare they have to accept a standardized supplement. They may not accept a Medicare Advantage or a Medicare Supplement Select plan.
http://www.medicaresupplementnews.com/]Medicare Supplement News
Is it to late to apply for a medicare supplement insurance plan
I am not finding an answer to my question---Are the premiums on my medicare supplement tax deductable? Please help!
You have Medicare as primary insurance and BCBS as secondary insurance Do you pay the copay on the secondary insurance?
The answer to this question depends on what kind of secondary insurance you have - is it a group health plan? Is it a supplement? If Medicare is primary, there are still deductibles, copays, coinsurance that would need to be satisfied by your secondary insurance. Based on your question, I'm assuming that you have a group health plan with a copayment as your secondary insurance. If so, then yes, you would pay your copayment but… Read More
Medicare supplement pays part or all of your deductibles and copays that you have with Medicare parts A and B. A "Medicare replacement" is actually Medicare advantage. They are a Medicare option that combines your Part A, B and sometimes part D into one plan that is administered by a Medicare contracted insurance company. Many of these plans have very low or even 0 monthly premiums. You still have copays but they are generally much… Read More
Medicare supplement insurance, sometimes called Medigap, helps cover some of the costs not covered by Medicare. It is purchased from private insurance companies and is different from the Medicare Advantage Plan.
To add, a supplement plan is called a Medigap Insurance policy. It, like Medicare, will not pay for everything but will pick up most of the difference between what Medicare covers and the normal office/procedure charges.
Medicare supplements are private insurance plans.
It's the provider's office responsibility to forward the bills to the correct insurance for payment. When using Medicare along with a Medicare Supplement, you'll show both your Medicare Card and your Supplement insurance company's card at time of payment. The provider's office will bill each card accordingly.
There are a few benefits to purchasing a Humana Medicare supplement. Humana is a good supplement because it is very worthwhile in one's old age as it provides thorough coverage.
No. There is a federal law that requires Medicare is a secondary payer. You can find more information on the CMS website under "Medicare Secondary Payer and You."
WHEN MEDICARE IS PRIMARY, THE PATIENT IS RESPONSIBLE FOR THE SECONDARY COPAY.
That would be covered under the terms of your policy. In general that is what supplemental, (secondary) insurance is primarily for. Most "supplemental" plans pay the 20% that Medicare didn't pay only AFTER seeing an "explanation of benefits" statement--i.e. proof that Medicare paid their part. If Medicare denies a service all together, the supplemental plan is often under no obligation to pay at all, as they are there to "supplement" Medicare, not take the place… Read More
We have Medicare and added on Anthem. Does that mean Medicare is primary (Paying 80 percent) , and Anthem is secondary?
The EOB (Explanation of Benefits) is what explains Medicare's payments and denials. Sometimes it is referred to as an EOP (Explanation of Payment). This document will show all items filed on a particular claim for a particular provider. It will show which items were covered or noncovered and why, which items were denied and why, and which items were paid. It will also show the patient's responsibility as far as deductible and coinsurance goes. If… Read More
If you already have Medicare Part A and are enrolled in Medicare Part B, you can get a Medicare Supplement. When it comes to having insurance at work, take a look page 16 in the 2009 Medigap Book: http://www.medicare.gov/Publications/Pubs/pdf/02110.pdf
AARP Medicare Supplement Insurance picks up the Medicare deductible.
after getting the payment from medicare (Primary) then secondary (X/Y/Insurance should pay even if there is no auth. And only this happens if secondary insurance follow medicare guidelines.
The answer is really based on an individuals personal circumstances. Each type of coverage has various pro's and con's. The biggest difference is that a Medicare Supplement is a supplement to Original Medicare. Original Medicare rules and coverages apply and then the Medicare Supplement plan covers all or a portion of the beneficiary's responsibility and may provide additional benefits that Medicare doesnt cover. This gives you the most choice because you can go to any… Read More
Does medicare part a pay the difference after Blue Cross which is primary carrier paid most of the claim for skilled nursing facility I have a 290 balance due the nursing facility?
Medicare does offer coverage for skilled nursing facilties. In order to find out if Medicare will pay as your secondary, the provider needs to submit it to Medicare. This statement is from the Meidcare.gov website: Medicare providers must submit claims (bills) to Medicare for you, whether Medicare is your primary or secondary insurer. For Medicare to process a claim as a secondary payer, the provider must give your primary insurance information to Medicare. You may… Read More
Medicare Supplement leads are information packets purchased from companies that give information about patients that will soon be eligible for Medicare. These companies track personal data about individuals and then sell them to interested insurance companies.
ZERO! Don't confuse Medicare Advantage with Medicare Supplemental Insurance. It's like confusing the dog with it's terd.
Yes, Medicare Supplement Insurance covers dependents and children up to the age of fifteen according to their guidelines which are listed on their website.
No it is not. Medicare Part C plans otherwise known as Medicare Advantage Plans are private insurers that maintain a contract with Medicare to provide Medical Coverage and/or Prescription Drug Coverage plus in some cases added benefits not usually covered by Medicare (like dental, vision, etc) Medicare Supplement plans which have been standardized into various benefit plans labeled from A-N work in conjuction with Original Medicare and provide supplement coverage for costs that are normally… Read More
medicare does not covere preventative. you need a HMO/PPO policy or a supplement
Do you have to pay the medicare deductible if they are paying secondary to a primary insurance carrier?
Every covered life, whether utilizing Medicare as primary or secondary insurance is subject to the same, annual Medicare deductible.
There are dozens of Medicare supplement insurance companies to choose from. AARP, Colonial Penn Life, and Gerber Life Insurance are just a few of the more popular companies.
If you are working then medicare is secondary (always)
The type of supplement plans that are offered by Medicare depend on the area in which you live. Even then they use vague plan names like "Plan A" or "Plan B". Each of these services vary in how much Medicare will help pay for one's medication.
Medicare is primary if your group is under 20 lives. 20 lives or more and medicare is secondary to your employer paid group plan.
Are you on Medicare? If so, you can look into a Medicare Supplement or a Medicare Advantage Plan with BlueCross BlueShield of your state of residence.
Medicare is the Government program that provides health insurance for people are over the age of retirement or who receive disability benefits from Social Security. A majority of these people also purchase what is called a Medicare Supplement Policy that pays the difference in what Medicare pays and what is actually billed to the person.
With medicare can I have two supplement health insurance
If you have medicare and your spouse also has you as a dependent on their insurance which is primary and which is secondary?
Medicare is primary unless you are working and have coverage thru your employer. Coverage thru the spouse's employer would be secondary to your own Medicare coverage. NO. The answer posted above is incorrect! Medicare is Secondary. Medicare is secondary when : -The individual or his/her spouse is currently employed/working and covered under an employer group health plan as a result of current employment see this link http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=871
You submit an EOB from the Medicare HMO with your Medicaid claim.
The benefits of purchasing an AARP Medicare supplement are many. This supplemental insurance plan offers extra coverage above what Medicare covers, deductibles are lower, and there are more service providers who accept this supplemental insurance than other similar plans through other companies.
Medicare does not offer complete health insurance protection. Medigap insurance is a type of plan intended to supplement Medicare coverage
There are many different varieties of benefits of purchasing AARP Medicare supplement insurance. These benefits include, but are not limited to, having access to more health products and having more prescription medications paid for.
This is one of the many limitations with medicare, supplement policies often have coverage for travel.
One may purchase AARP Medicare supplemental insurance through United Healthcare. The insurance helps retirees to supplement their original Medicare coverage.
Is Blue Cross and Blue shield who you would call to get additional coverage to Medicare Parts a and b?
Several insurance companies offer Medicare supplement plans.
As long as the only reason you are covered by Medicare is because of a disability and you haven't reached the minimum age Medicare requires to become eligible naturally, then the number of members in the group health plan will determine who is primary or secondary. Group plans with fewer than 100 members are considered to be "small" businesses and Medicare would be primary. Conversely, "large" businesses (more than 100 members) will be primary over… Read More
Medicare part A = Hospital and Facility coverage Medicare part B = Professional (doctors and specialists) coverage Medicare part D = Rx Medicare part C = Part A B D combined After part C refers to supplement plans
The "best" supplement is the one that you can afford. Here's how the supplements work: Medigap, also called a Medicare Supplement, basically pays the portion of medical expenses that Medicare expects you to pay. Medicare is an "80/20" plan, meaning Medicare pays 80% of the bill and you pay 20% of the bill. Medigap can pay the 20% for you. Depending on which Medigap plan you choose, the plan can also pay the (2009) $1068.00… Read More
Medicare is always the primary insurance unless someone is still working
When someone is approved for a Medicare plan they often get pamphlets and paper work for doctors that will accept Medicare insurance. The United States government also has a website and you can get information from there.
Medicare Supplement Insurance provides health insurance for people older than 65 years or people under 65 with certain disabilities or people of any age with end-stage renal disease.