Do any of you know how it works when you have HC ins. &

[napi21]

also have Medicare Part A as the secondary?

The paramedics just took my husband to the ER today. So far, they can't tell me much because the test results haven't come back yet, but they are going to admit him, and they think it's heart related.

I'm asking because last year I went to the ER for a broken ankle, and we ended up having to pay $2,500 out of pocket because of pieces and parts of things were only paid partially. BTW, $2,500 was the max out of pocket we had to pay because the ins. policy has a cap on it.

With medicare as a secondary, does that mean we won't be hit so hard? We're doing ok, but sure can't afford an extra $2,500 a year!

Sorry to bother you guys with this, but I feel you are all my friends and somebody here ALWAYS has the answers.

Thanks

[Donnachaidh]

1. It depends -- are you sure the hospital will file the paperwork?

I don't want you to panic, but I've had to really keep on medical offices *and* hospitals to file the paperwork, so that Medicare will kick in. They *claim* it's a pain to have to file duplicate forms, but I suspect they don't like to do it because of the caps used by Medicare for charges.

Your best bet would be to call Medicare, and ask them what is the normal course. And if there is anything you can do to be sure paperwork is filed.

[pinto]

2. If your husband is *admitted*, Medicare Part A will kick in as a secondary.

(Part A doesn't cover ER visits, or any other out patient services. That's Part B. Check your husband's Medicare card. It'll list what he has.)

Make sure the hospital has all the info for billing both your primary insurance and Medicare.

Typically Medicare pays 80% of what they term "allowable cost". If your primary insurance covers less than that, they will pick up the difference, up to that 80% of allowable cost limit.

One request that's always worth making is to ask the hospital to accept "assignment". That means they agree to accept insurance/Medicare payments as payment in full.

Another is to ask for assistance from a hospital patient services representative or ombudsman and a discharge coordinator.

Note that physician services may be billed separate from hospital inpatient costs, so the same steps apply to the physician billing. And ask them to accept "assignment" as well.

Good luck. Hope your husband is fine.

On line info is available at http://www.medicare.gov or at 800-633-4227

[classykaren]

3. Pro Life

Is anyone here interested in having a pro life group started I made one statement that I was a pro life democrate and got blocked from the choice section I wrongly thought that was what a discussion group was not everyone with the same opinion I read if I have 10 other people interested we can have a group there are millions of pro life democrates and we are good democrates too

[mitchtv]

4. You should start a thread to get it started

ot thread jack a divisive issue into this person's thread. I don't know if you have enough post to start your own but make but the criteria is set ppretty low, so make a few more posts, and let'r rip. Welcome to DU. Make sure you define Pro life, if it means anti-choice, you will run into a lot of resistence. I am presuming you are not anti choice, cause if you are you will have even fewer recruits.