Medicare Problems

[Katsmeow]

Traditional Medicare has copays also, right?

Depends on what supplement you have. For example with Plan F, the supplement picks up all copays and deductibles. DH has Plan F.

My mother has Plan G. She is responsible for the deductible of I think $183 and then everything else is picked up.

 

[aja8888]

I've read- maybe here on another discussion- that M.D. Anderson in Houston doesn't take Medicare Advantage. I sincerely hope I'll never need them (don't even live in the area) but that's a pretty big player opting out.

That is correct.

 

[Telly]

Here ya go, MD Anderson Medicare, Medicare Advantage, and Medigap

https://www.mdanderson.org/patients...ling-financial-support/medicare-medicaid.html

 

[youbet]

Here ya go, MD Anderson Medicare, Medicare Advantage, and Medigap

https://www.mdanderson.org/patients...ling-financial-support/medicare-medicaid.html

Thanks Telly!

Medicare Advantage plans are not my personal first choice. But there seems to be some serious misconceptions and confident sounding spreading of incorrect information which should be corrected.

It is NOT correct that M D Anderson accepts NO Medicare Advantage plans. But it is correct that there are many different Medicare Advantage plans on the market. Some are open to all comers. Some are restricted to certain groups such as retirees from certain employers. Some have restricted networks and some have the same networks as traditional Medicare. Your group plan eligibility and your geographic location seem to be important factors in determining which plans are available to you.

From the link to M D Anderson Telly provided:

Medicare Part C, also known as the Medicare Advantage Plan, replaces traditional Medicare. Kelsey-Care Medicare Advantage is the only Medicare Advantage plan with which MD Anderson is contracted. However, we have a working relationship with some Medicare Advantage HMO and PPO plans. Please contact your plan to determine if they will work with MD Anderson.

 

[harllee]

OP here. Out of the blue today I got a call from someone in Medicare Advanced Resolutions, and without me giving him my SS# the caller would not tell me what it was about. I was driving and did not want to give my personal info so they told me to call into Medicare. Later I was able to call into Medicare. After being put on hold numerous times (total call was over an hour), the Medicare Advance Resolution people told me they had figure out I was incorrectly billed for 2 deductibles in 2017. Well ,duh, Medicare has been saying this for about 6 months and I have been trying to get reimbursed for 6 months. They said they would have to refer this matter up to a higher level, that I would have to send in more information (information I had already mailed in twice) and they would get me reimbursed for the extra $183 deductible I had paid. I told them no thanks, I had spent all the time on this I was going to, that I was not going to mail them the same information for a third time and they could just keep the $183. They said they could not do that--I was owed $183 and they would have to get it to me. I said again I was not going to spend any more time on it. The final thing I was told was that they were sending my matter to appeals and I would hear back in 45 days. SMH. And to think my taxes are paying the salary for these employees.

 

[aja8888]

OP here. Out of the blue today I got a call from someone in Medicare Advanced Resolutions, and without me giving him my SS# the caller would not tell me what it was about. I was driving and did not want to give my personal info so they told me to call into Medicare. Later I was able to call into Medicare. After being put on hold numerous times (total call was over an hour), the Medicare Advance Resolution people told me they had figure out I was incorrectly billed for 2 deductibles in 2017. Well ,duh, Medicare has been saying this for about 6 months and I have been trying to get reimbursed for 6 months. They said they would have to refer this matter up to a higher level, that I would have to send in more information (information I had already mailed in twice) and they would get me reimbursed for the extra $183 deductible I had paid. I told them no thanks, I had spent all the time on this I was going to, that I was not going to mail them the same information for a third time and they could just keep the $183. They said they could not do that--I was owed $183 and they would have to get it to me. I said again I was not going to spend any more time on it. The final thing I was told was that they were sending my matter to appeals and I would hear back in 45 days. SMH. And to think my taxes are paying the salary for these employees.

Same thing happened to me on a $20 overpayment on deductible. However, my Medigap insurer would not process claims until it was resolved.
Be careful with this. It took me 6 months to straighten it out. Each case may have different outcomes, however.

 

[harllee]

Same thing happened to me on a $20 overpayment on deductible. However, my Medigap insurer would not process claims until it was resolved.
Be careful with this. It took me 6 months to straighten it out. Each case may have different outcomes, however.

Thanks for this tip. So far my Medigap plan has been processing my claims with no problem. I figure I have spent at least 10 hours on this $183 issue and I am not planning to spend a minute more on it if I can avoid it. My time is more valuable than this.

 

[aja8888]

Thanks for this tip. So far my Medigap plan has been processing my claims with no problem. I figure I have spent at least 10 hours on this $183 issue and I am not planning to spend a minute more on it if I can avoid it. My time is more valuable than this.

When this happened to me, Medicare said I had to get the error resolved with a billing code reversal. It took me a few months to figure out where the billing was done (Dr's office wouldn't help) and I finally got it resolved. I switched doctors over this.

Maybe you will get lucky and Medicare will send you the money at a later date.

My issue was that my Medigap insurer made the deductible over-payment (I had Plan F), so they had the ball, and would not accept a $20 payback check from me. They had to get the reversal paperwork and the money from the payee, who was the doctor's office, which used a third party billing company (in India).