Medicare question

Discussion in 'Homesteading Questions' started by 65284, Aug 3, 2005.

  1. 65284

    65284 Well-Known Member Supporter

    Messages:
    2,349
    Joined:
    Sep 17, 2003
    Location:
    Missouri
    Can anyone tell me if Medicare claims must be filed by the doctor? I will have to go on Medicare my next birthday and my present ins. becomes the secondary payer. Our doctor doesn't file insurance claims, we pay at the time of service and receive a discount. He does give us the completed and signed forms which we send in and and receive payment directly from our ins co. I sure would hate to have to find a different doctor, this one has finally got me straightened out and feeling pretty good. But, my ins. won't pay anything until Medicare does so I may have to change, I can't afford to pay it all out of pocket.
     
  2. ralphsmom

    ralphsmom Well-Known Member

    Messages:
    49
    Joined:
    Mar 21, 2005
    Location:
    No. California
    All of the doctor's and hospitals I've gone to have done the Medicare billings. Medicare is my only health provider (can't afford supplemental) and they've really paid very well. Hospitals write off quite a bit. Marilyn
     

  3. Mudwoman

    Mudwoman Well-Known Member

    Messages:
    528
    Joined:
    Dec 18, 2002
    You will have to find a Doc that takes Medicare patients and does the filing. Filing the paper work for medicare is a nightmare and more and more Docs are doing what the Doc you are seeing is doing. You pay him and then worry about getting your insurance reimbursements------which will make it almost impossible for you with medicare. My parents, when they were alive, had to move to another town to find docs that would take medicare patients and file the paper work because where they were, most all the docs wouldn't.
     
  4. FiddleKat

    FiddleKat Mother,Artist, Author Supporter

    Messages:
    3,532
    Joined:
    Oct 22, 2004
    Location:
    East Tennessee
    I think you have to apply and the doctor would submit. But I am could be wrong on this.
    My 7 yr old daughter is on Medicare (MassHealth-state version) and intinally when we applied for SSI we had to have paperwork like you wouldn't believe and the doctors signing it.
    www.medicade.gov
    that might be a link to find out.

    Kat
     
  5. uncle Will in In.

    uncle Will in In. Well-Known Member Supporter

    Messages:
    7,154
    Joined:
    May 11, 2002
    If the Dr accepts you as a patient, he is required to file your claim with medicare. In doing so he also shows your co=pay insurance company. Medicare will allow whatever portion of his bill they decide such treatment is worth. Of this amount, they pay 80 percent, and send you and your co-pay company a copy of their payment amount billing. Your co-pay company will pay the other 20 percent of the allowed amount and foward you a notice of what they payed. The Dr or hospital has to drop the amount they didn't get above what Medicare allowed them. This can sometimes be more than half of what they charged. When you get a Dr, you need to ask if he accepts Medicare assignment. If he does you seldom owe any more than medicare allowed. Even if he dosen't you still can't be billed more than 10 percent more than the allowed amount.
     
  6. uncle Will in In.

    uncle Will in In. Well-Known Member Supporter

    Messages:
    7,154
    Joined:
    May 11, 2002
    Companys that sell Co-pay insurance all are reguired to offer the same benifits with each type of policy they have to offer. All of the companys have to show what each lettered policy pays, The insurance starts out under group A which costs the least and pays the least. As the letters of the group goes up so does the benifits and likewise the premiums. Plan C is about the most popular plan. The difference between the companys is the amount of their premiums for the identical plan.
    You should ask your company for their co-pay plans so you can examine them and check with other companys as well.