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A Medicare Strategy
Old 02-17-2016, 08:25 AM   #1
Thinks s/he gets paid by the post
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A Medicare Strategy

More properly, "My" Medicare strategy, 'cuz it's what we do to keep our sanity when the medicare statements come in.

We wait... two months... sometime three, for everything to "shake out".

In the early years, (we've been on Medicare for 15 years) when we got the statements... sometimes as many as ten or more pages, panic would set in. Phone calls and looking up unfamiliar terms, and worry... worry... worry. Some statements that detailed tens of thousands of dollars.

So, after the first few years, my older next door neighbor told us to just put the bills/statement, in a pile and not to do anything until a letter comes from the healthcare provider, threatening our credit standing. (Only twice in all of those years, when we got mixed up on the initial $135 co-pay).

At one point, when I was taking care of an elderly friend, I uncovered his cache of Medicare bills (literally thousands of pages)... every month for five years... piled up in a large box. This was before i learned about the "wait" strategy, and I spent days trying to straighten out his doctor bills. The net result was that nothing had to be done. Lesson learned.

Now, your mileage may vary, so I'm not suggesting that YOU do this, but it's the way we stay calm, and so far, it has worked.

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Old 02-17-2016, 08:44 AM   #2
Recycles dryer sheets
Join Date: Jul 2011
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Posts: 131
+1 on this - not just for Medicare but also regular insurance. DW worked for a large health insurance company for 26 years, everything from claims to fraud investigation to new business. What typically happens is:

First bill - "rack" rates (no insurance company negotiated discounts), "unbundled" charges (separating every item on a procedure to charge higher individual rates), no indication of what insurance will actually pay. Just set this one aside.

Second bill - Insurance company discounts applied, easier to see denied charges, maybe insurance payment received. Now is the time to look & inquire about charges they want you to pay because insurance won't. Nope, don't pay it yet.

Third bill - Insurance payments applied, typically this bill has the bottom line you will have to pay. Still worth perusing to look for anything that looks strange or unnecessary. Now you can pay.

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Old 02-17-2016, 08:47 AM   #3
Thinks s/he gets paid by the post
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It wouldn't work in our case. I'm still trying to get a particular provider to submit their bills to DH's Medicare Supplement carrier for treatments starting last September. I called and gave them the policy info. On two different occasions the providers have said they've submitted them. They don't show up on the Medicare Supplement carrier's site in the claim listing. Up to now the insurer (United Healthcare) has promptly processed claims from other providers so I don't think they're causing the delay.

Sigh. I think I'm just going to get copies of Medicare's benefits statements for the charges and forward them to UHC myself. I expect to get about $400 from UHC so it's worth it.
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Old 02-17-2016, 08:57 AM   #4
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When we became responsible for DH's father's care -- literally overnight, when he was involved in a bad car accident -- we were absolutely clueless about Medicare and Tricare (he was retired military).

The medical bills came pouring in, some marked "final notice" or other dire warning. His Medicare and Tricare statements were pages* long (FIL had chronic health conditions to begin with, but once all his hospitalizations and treatments for the car crash kicked in ... oh my).

(*Ed. to add: one of his monthly statements -- from either Medicare or Tricare, I forget -- was Twenty.Four.Pages.Long.)

In a panic, I paid one of the most persistent bills, for ambulance and EMT services after the crash.

Sure enough, a few months(!) later, pouring over FIL's huuuge Tricare statement, it showed Tricare paid that same ambulance bill. I think we managed to have our payment refunded, but that time was such a blur ...

But I did learn not to panic when the bills came in, it took several months before Medicare and the supplemental policy caught up. In the meantime, some providers billed FIL directly. I just put those bills in a big ol' pile and checked them off when they eventually showed up as paid on the Medicare or the Tricare statement. And IIRC, they were all paid ... eventually.
Doing nothing is underrated.
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