Medicare Part G Supplimental Plan(s)

[ShokWaveRider]

OK, so here's the story. I went on Medicare this year in January. Called Boomer Benefits, all good, very easy, ended up with the AARP UHC Plan G and WellCare Part D (All BP Drugs I take are Free from Publix with or without Insurance).

So, I had no doc visits until July 2019, then all the regular checkups, doc wanted and ordered 2 CT Scans and an Ultrasound. Had 2 semi-annual pacemaker diagnostic checks. Then a dermatology and retina specialist appointment. Then most recently a Pacemaker replacement (Outpatient). All in all a pretty active year for me so far.

Well so far I have not received any bill for my $185 deductible, remember Plan G is not like Plan F, it does not cover the Medicare deductible.

I checked with the doctor, imaging center and cardiologist, and they say they are all paid up. I have not seen anything yet for the Pacemaker replacement as it was only 3 weeks ago.

Any ideas why I have not had the invoices for the deductible, are they that slow? Regardless I thought the invoices would come from the providers not Medicare anyway.

 

[MichaelB]

Have you checked your UHC-AARP explanation of benefits? That should clarify your financial responsibility.

 

[ShokWaveRider]

Have you checked your UHC-AARP explanation of benefits? That should clarify your financial responsibility.

Yes, I get them periodically from Medicare that shows what they paid vs what was not. I have not received anything from UHC-AARP...… yet.

 

[MichaelB]

Yes, I get them periodically from Medicare that shows what they paid vs what was not. I have not received anything from UHC-AARP...… yet.

You have no financial liability when the EoB shows that. Until then, the claim probably has not been submitted. You can always check online at UHC-AARP.

 

[NoMoreJob]

The $185 should show up on one of your first billing or billings of the year as an amount that Medicare didn't pay and you were responsible for. It probably won't be clear that you owed it due to the deductible.

Go to MyMedicare.gov, log into your account and click on 'My Claims' and then 'Check my Deductible Amount' you'll see your deductible amount and how much of it has been met. My bet is that you paid it but just didn't realize it.

 

[ShokWaveRider]

Go to MyMedicare.gov, log into your account and click on 'My Claims' and then 'Check my Deductible Amount' you'll see your deductible amount and how much of it has been met. My bet is that you paid it but just didn't realize it.

Thanks, did that, should deductible now to be $0, but I definitely did not pay anything towards it yet. Is it possible the providers just absorb it? Or, it just has not come through yet. It was met about 2-3 months ago.

 

[REWahoo]

Any ideas why I have not had the invoices for the deductible, are they that slow? Regardless I thought the invoices would come from the providers not Medicare anyway.

My experience is some providers can be months in submitting bills. What they typically do is first submit to Medicare and your supplement insurer, then once those two have paid the provider what they say they owe, the provider sends you an invoice for anything remaining you may owe. It can take a quite a while.

 

[NoMoreJob]

Thanks, did that, should deductible now to be $0, but I definitely did not pay anything towards it yet. Is it possible the providers just absorb it? Or, it just has not come through yet. It was met about 2-3 months ago.

This is what mine says indicating that my deductible is $185, that I've paid that $185 (under 'deductible met') and that there is $0.00 left for me to pay......

Deductible Year
2019
Part B Deductible Amount
$185.00

Part B Deductible Remaining
$0.00
Deductible Amount Met
$185.00

Occupational Therapy Applied
$0.00
Physical Speech Therapy Applied
$0.00

I suppose it's always possible that a mistake was made on Medicare's part. In my case they've always covered the deductible through one or more early claims but there's never any indication that I'm paying the deductible. It's just an amount(s) due to the provider(s) that Medicare doesn't cover and may be smaller amounts that add up to the annual deductible amount from multiple early bills.

 

[ShokWaveRider]

This is what mine says indicating that my deductible is $185, that I've paid that $185 (under 'deductible met') and that there is $0.00 left for me to pay......

Deductible Year
2019
Part B Deductible Amount
$185.00

Part B Deductible Remaining
$0.00
Deductible Amount Met
$185.00

Occupational Therapy Applied
$0.00
Physical Speech Therapy Applied
$0.00

I suppose it's always possible that a mistake was made on Medicare's part. In my case they've always covered the deductible through one or more early claims but there's never any indication that I'm paying the deductible. It's just an amount(s) due to the provider(s) that Medicare doesn't cover and may be smaller amounts that add up to the annual deductible amount from multiple early bills.

That is exactly what mine says too. But I have not paid anyone anything...., yet.

 

[NoMoreJob]

That is exactly what mine says too. But I have not paid anyone anything...., yet.

Have you been responsible for paying any amount(s) directly to any of your healthcare providers this year?

 

[audreyh1]

Hey, sounds good to me!

 

[ShokWaveRider]

Have you been responsible for paying any amount(s) directly to any of your healthcare providers this year?

It says I am responsible on the EOB. But again I have not been invoiced yet, even for services as long ago as Feb 2019.

 

[NoMoreJob]

It says I am responsible on the EOB. But again I have not been invoiced yet, even for services as long ago as Feb 2019.

I suppose you can just wait but you are risking legitimate billings turning into problems for you down the road. The billings can take awhile but six months is a long time.

It's unlikely that the providers have chosen to absorb charges that you are responsible for but if they have for some reason I'm sure they would tell you if asked.

 

[ShokWaveRider]

I suppose you can just wait but you are risking legitimate billings turning into problems for you down the road. The billings can take awhile but six months is a long time.

It's unlikely that the providers have chosen to absorb charges that you are responsible for but if they have for some reason I'm sure they would tell you if asked.

I have asked if I owe them any money, they have said no. That should be good enough I think. I know them all personally and they know me and I have never been delinquent. They have always let me know if I have failed to pay a co-pay or something in the past when I was on an ACA plan.

 

[audreyh1]

I have asked if I owe them any money, they have said no. That should be good enough I think. I know them all personally and they know me and I have never been delinquent. They have always let me know if I have failed to pay a co-pay or something in the past when I was on an ACA plan.

Yes, I would think so.

 

[kaneohe]

Perhaps verify that you are really in Plan G?

When I was in F, it took forever to get statements from provider. When I switched to Plan G, as soon as I got on provider's site, staring me in the face was "I owe xxx $$. Want to pay now?"

 

[ShokWaveRider]

Perhaps verify that you are really in Plan G?

That is what it says on my card.

 

[kaneohe]

That is what it says on my card.

I believe that but the other actors seem like they think you are F.
Perhaps double verify w/ the provider that they really have been paid
and if so who paid them. Maybe they are mistaken about having been paid?

 

[travelover]

I say keep your head down. Worst case, you get billed for the $183, best case, they don't.

 

[NoMoreJob]

I have asked if I owe them any money, they have said no. That should be good enough I think. I know them all personally and they know me and I have never been delinquent. They have always let me know if I have failed to pay a co-pay or something in the past when I was on an ACA plan.

You've got me.

 

[Never2L8]

My husband went on plan G this year also. His first claim was from January and the MSN (and online) showed that $185 was applied to the deductible and he was responsible. The provider billed for that $185 in May. I'm guessing your provider's billing will catch up and bill you eventually.

 

[Telly]

My experience is some providers can be months in submitting bills. What they typically do is first submit to Medicare and your supplement insurer, then once those two have paid the provider what they say they owe, the provider sends you an invoice for anything remaining you may owe. It can take a quite a while.

Me too.
I started to worry earlier this year about all of my (last years) Plan G deductible not being billed to me yet. After a while, I even tried to pay it at the Ophth. practice, and they wouldn't take my money. They said they had nothing to bill it against. They said it eventually would come through to them, then they would bill me. It eventually did.

Though the mills of Medicare grind slowly, yet they grind exceedingly small...

There's no rushing the Miller.

 

[travelover]

...........Though the mills of Medicare grind slowly, yet they grind exceedingly small...

There's no rushing the Miller.

I talked with a couple retired docs recently and we got into the topic of Medicare payments. They both said they preferred Medicare to private insurers because of faster and surer payment, even if it was less. Private insurers, they said, bounced bills back again and again over coding, etc. and also squabbled with other insurers where there was any ambiguity on responsibility.

 

[trumpeting_angel]

My first EOB from Medicare said that the expense wasn’t covered, and it was paid in full and the deductible wasn’t charged. I spent a little while wringing my hands over this, then decided it wasn’t worth reading the 3 pages of fine print and doing research to figure out why. I’m on a Plan G supplement also, but this EOB was from Medicare itself.

I suppose I’ll have to be more proactive if there are complex bills to come, but I’m hoping not; that was one of my reasons for Plan G.