Yes, you can be denied Medicare coverage even if you are a citizen of the United States. Having an income higher than Medicare's current guidelines can disqualify you. There are many other reasons which are all described on the government's Medicare website at medicare.gov.
Medicare reason code CO16 indicates that the claim has been denied because the procedure or service is considered to be not medically necessary according to Medicare guidelines. This means that the treatment provided does not meet the criteria for coverage under Medicare's policies. Providers may need to review the documentation and possibly appeal the decision if they believe the service was necessary.
It depends on the reason you were denied.
CPT code 87002, which refers to the culture of bacteria from a specimen, is typically covered by Medicare when medically necessary and performed in accordance with applicable guidelines. However, coverage can depend on specific circumstances, such as the patient's condition and the reason for the test. It's important for providers to check with Medicare or review their local coverage determinations for any specific requirements or limitations.
The "D2" designation on a Medicare card typically indicates that the individual is eligible for Medicare due to a disability. This designation is used for beneficiaries who qualify for Medicare coverage because they have received Social Security Disability Insurance (SSDI) for 24 months or have specific conditions like End-Stage Renal Disease or Amyotrophic Lateral Sclerosis (ALS). It helps healthcare providers and insurers identify the reason for a person's Medicare eligibility.
Question is who is primary health coverage and second and even third. I have a retirement coverage only with basic coverage, big deductibles, big copay and big out of pocket, but free. I how have Medicare with part B and very close in chasing either a medicare supplement plan or a medicare advantage plan in Lu of original medicare. Also I am covered under my wife's employment health coverage under her policy. Question who is first or primary, medicare or the coverage taking place of medicare, my retirement policy with lowest basic coverage or wife's coverage from work also coverage me. The answers I get are all different depending on either coverage I ask. Please help me, thanks
You can be denied work for any reason.
Generally yes. Most employer coverage is guaranteed issue. If you applied for an individual coverage and were denied for underwriting reasons that should have no effect on the employer plan. In fact, it is common for someone with an uninsurable condition to make the availablility of health insurance a prime consideration when looking for a new job for this very reason.
No
That depends on why you were denied. If the reason you were denied was remedied then you can reapply.
Poor plight of labours was the main reason. they were treated as third citizen and their rights were denied.
Yes - Aetna just did it to us because our daughter has asthma. I was so shocked. They stated the reason that her combined conditions of asthma and eczema (yes mild eczema - at least for her) "exceed the allowable limit provided by our underwriting guidelines" As of January 1st, 2014, this is no longer permissible. No existing condition can be a reason for declining coverage. This is one of the changes that the PPACA (ObamaCare) made.
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