medicare question

[ripper1]

Wife was sent for bloodwork that does not take medicare assignment. We are new to medicare and shame on them because we probably should have done it there. We were shocked when the facility told us we had to pay the cost of 400 dollars for the tests because they didn't do medicare. I believe the test were routine and have found out they probably wouldn't pay anyway. But we have a medigap plan also from mutual of omaha and thinking shouldn't they paying for what medicare is not?

[Telly]

A Medigap insurer only pays their portion of Medicare-approved expenses. If Medicare won't pay, Medigap won't. Think of Medigap as an adjunct to Original Medicare. Sorry...

[jimandthom]

Quote:

Originally Posted by ripper1;2328120[COLOR="Red" ]Wife was sent for bloodwork that does not take medicare assignment. We are new to medicare and shame on them because we probably should have done it there.[/COLOR] We were shocked when the facility told us we had to pay the cost of 400 dollars for the tests because they didn't do medicare. I believe the test were routine and have found out they probably wouldn't pay anyway. But we have a medigap plan also from mutual of omaha and thinking shouldn't they paying for what medicare is not?

You say that wife went for blood draw at a place that doesn't accept Medicare/assignment. At the end of the highlighted you say "shame on them we probably should have done it there." Were you at one location(where the Dr that wrote the order practices) and went to another for the draw?

Also confused about you saying/believing the tests were routine but they probably wouldn't pay anyway.

Did they tell you at time of registration about not accepting Medicare/assignment or did they do the draw and then inform.

I'm a bit confused here.

As previous posted mentioned usually medigap won't pay is Medicare doesn't.

[aja8888]

The first thing I do when I go to a new medical facility is ASK if they take Medicare. If they say no, I leave.

[braumeister]

Quote:

Originally Posted by aja8888 The first thing I do when I go to a new medical facility is ASK if they take Medicare. If they say no, I leave.

The first thing any medical facility asks me when I make an appointment is what insurance do I have. When I say Medicare, the normal response is "That's fine." If they said anything else I would go elsewhere.

[REWahoo]

Quote:

Originally Posted by aja8888 The first thing I do when I go to a new medical facility is ASK if they take Medicare. If they say no, I leave.

Rather than ask if they accept Medicare I think a better/more accurate question to ask is "Do you accept Medicare assignment?" I'm concerned they can say yes to the "take Medicare" question and still bill for excess charges.

[Car-Guy]

Quote:

Originally Posted by aja8888 The first thing I do when I go to a new medical facility is ASK if they take Medicare. If they say no, I leave.

+1, but I haven't had to walk out nor have I been surprised billed,,,,, Yet!

[MichaelB]

Quote:

Originally Posted by REWahoo Rather than ask if they accept Medicare I think a better/more accurate question to ask is "Do you accept Medicare assignment?" I'm concerned they can say yes to the "take Medicare" question and still bill for excess charges.

+1

[aja8888]

Quote:

Originally Posted by REWahoo Rather than ask if they accept Medicare I think a better/more accurate question to ask is "Do you accept Medicare assignment?" I'm concerned they can say yes to the "take Medicare" question and still bill for excess charges.

I have heard that "excess charges" billing will be not an issue after 12/31/19. I don't have any source, although I read this recently in a local publication. This may just be for Texas, though.

[aja8888]

Quote:

Originally Posted by REWahoo Rather than ask if they accept Medicare I think a better/more accurate question to ask is "Do you accept Medicare assignment?" I'm concerned they can say yes to the "take Medicare" question and still bill for excess charges.

Yeah, that'sw hat I meant. You guys are tough and I'm on pain pills right now.

[REWahoo]

Quote:

Originally Posted by aja8888 I have heard that "excess charges" billing will be not an issue after 12/31/19. I don't have any source, although I read this recently in a local publication. This may just be for Texas, though.

Hope it is accurate but I haven't seen anything about Medicare excess charges in TX. Wasn't there some state legislation on "surprise billing" relating to out-of-network insurance charges? Could this be what you read about?

[REWahoo]

Quote:

Originally Posted by aja8888 Yeah, that'sw hat I meant. You guys are tough and I'm on pain pills right now.

Take it easy - and maybe take a nap.

[aja8888]

Quote:

Originally Posted by REWahoo Hope it is accurate but I haven't seen anything about Medicare excess charges in TX. Wasn't there some state legislation on "surprise billing" relating to out-of-network insurance charges? Could this be what you read about?

Yes, that was it. I do need a nap......

[ripper1]

Quote:

Originally Posted by jimandthom You say that wife went for blood draw at a place that doesn't accept Medicare/assignment. At the end of the highlighted you say "shame on them we probably should have done it there." Were you at one location(where the Dr that wrote the order practices) and went to another for the draw? Also confused about you saying/believing the tests were routine but they probably wouldn't pay anyway. Did they tell you at time of registration about not accepting Medicare/assignment or did they do the draw and then inform. I'm a bit confused here. As previous posted mentioned usually medigap won't pay is Medicare doesn't.

We just messed up as I see it now. Should have asked that the outside lab took medicare first. Live and learn.

[Bamaman]

My pet peeve is getting a bill for a medical test, emergency room doctor, anesthesiologists or pathologists that doesn't accept my Medicare supplement.

In many places, emergency room doctors are just slave labor working for whatever they can squeeze out of insurance companies and patients. Many are not hospital employees of any kind. Pathologists often work for hospitals managing laboratories, but test reading is a sideline personal business of theirs. Same with radiologists.

Doctors' offices should know which insurance plans get sent to different medical laboratories, and have samples sent to the right place. On any test you get stuck paying, it never hurts to beg--and negotiate the payment.

On Emergency Room physicians, pathologists and anesthesiologists, it doesn't hurt to negotiate. But don't pay'em and they'll assign you to a collection agency that reports you to the credit bureaus and down goes your FICO score. It might affect your insurance rates and ability to borrow $ (if needed.)

Just ask on front end if the doctors and labs accept your insurance plan. Unfortunately when you're in distress from an accident or major ailment, asking questions is not the first thing on your mind.

[John Galt III]

Quote:

Originally Posted by Bamaman My pet peeve is getting a bill for a medical test, emergency room doctor, anesthesiologists or pathologists that doesn't accept my Medicare supplement. ...... Doctors' offices should know which insurance plans get sent to different medical laboratories, and have samples sent to the right place. On any test you get stuck paying, it never hurts to beg--and negotiate the payment. On Emergency Room physicians, pathologists and anesthesiologists, it doesn't hurt to negotiate. But don't pay'em and they'll assign you to a collection agency that reports you to the credit bureaus and down goes your FICO score. It might affect your insurance rates and ability to borrow $ (if needed.) Just ask on front end if the doctors and labs accept your insurance plan. Unfortunately when you're in distress from an accident or major ailment, asking questions is not the first thing on your mind.

Bamaman, I thought being on Medicare with a Supplement was how one avoided all this stress! (As opposed to being on a Medicare Advantage plan). You are bumming me out. I am on a MA plan now, and I have all that stress as well, but was keeping Supplement in the back of my mind as a future option.

[REWahoo]

Quote:

Originally Posted by Bamaman My pet peeve is getting a bill for a medical test, emergency room doctor, anesthesiologists or pathologists that doesn't accept my Medicare supplement.

I'm confused, is this a typo? If the medical provider accepts Medicare assignment they also accept your Medicare supplement.

[aja8888]

Quote:

Originally Posted by REWahoo I'm confused, is this a typo? If the medical provider accepts Medicare assignment they also accept your Medicare supplement.

That's the way it's worked for us for 10 years now.

[wmc1000]

We have used several lab locations for blood draw and not one has said they don't accept medicare assignment. Maybe OP took DW to a private testing lab? We have one by us that's called, (any lab test now), and they probably don't take medicare.

[CRLLS]

If any Dr or facility accepts Medicare patients and/or Medicare assignment, I didn't think they have the option of denying service based on the supplement plan, either provider or Plan letter. Perhaps they have mistaken your reply to be a Medicare Select Supplement Plan in which they may not in that plan. In that case, Medicare would still pay their 80% and you would be on the hook for the remaining 20%.