| Subject | Date Asked | Expert |
|
| Ret policy/COBRA | 11/5/2009 | John Pedit |
Q: A Wife that has BCBS COBRA through her employer who is covered under her husbands retired group ...
A: In this case COBRA would be her primary. However, check to see if they got letters from their ...
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| Ret policy/COBRA | 11/5/2009 | John Pedit |
Q: A Wife that has BCBS COBRA through her employer who is covered under her husbands retired group ...
A: Medicare is primary. However, there are missing factors in the question. Does she have Medicare ...
|
| billing a patient | 11/4/2009 | Tricia |
Q: I have recently taken over a billing postion at a medical clininc, and needless to say there is a ...
A: There is really no time limit set in stone in most states however most use 5-7 years......I would ...
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| med. coverage/MSA | 11/3/2009 | Tricia |
Q: My wife is pregnant with our first child, she is due in March 2010. The company I work for, and have ...
A: Cobra is usually offered when you leave the employment of a company not while you are still there ...
|
| Medicaid query | 11/3/2009 | John Pedit |
Q: My mother has been unable to work for years because of a long-time back problem that's gotten worse ...
A: SSI: Go to the local Social Security Office and get a copy of the SSI manual. Also get a copy of ...
|
| healthcare | 11/3/2009 | John Pedit |
Q: mom is 85y/o with dementia. living with me. she moved here 1 year ago,becouse of circumstanses. she ...
A: This is too complicated to be done by E-mail. Therefore I am referring you to my counterpart in ...
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| Medicaid | 11/2/2009 | John Pedit |
Q: My daughter a medicaid receipant was in Missouri for vacation when she became ill and had to go to ...
A: That is the problem with Medicaid. Each State is a separate identity and have their own ...
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| medicaid/hospital bills | 10/31/2009 | Tricia |
Q: . My fiance was in an accident and fractured his L1 vertebrea almost becoming paralized. Has been in ...
A: Not really sure since this is a legal question not a medical question. Most hospitals have a ...
|
| Non-medicare provider | 10/30/2009 | John Pedit |
Q: Recently my wife chose to work with a psychologist who does not accept payment from third parties. ...
A: I am not a lawyer and this is bordering more of a legal question than a Medicare question. A ...
|
| medicare & hmo's & fee for service plan | 10/30/2009 | Merry Schiff |
Q: I am currently enrolled in Aetna Open Acess HMO with Medicare as primary. I STILL GET BILLS FOR ...
A: I do not understand why you have Medicare and an HMO. Are you certain that you are not in an ...
|
| insurance refusal to pay for hip replacement | 10/29/2009 | Adelaide Rose |
Q: I am currently covered by my husbands medical insurance through his pipefitters local union #598. ...
A: Dona, I would have your doctor write a letter of medical necessity (if it's warranted) and have the ...
|
| Medicare Part D | 10/29/2009 | John Pedit |
Q: I recently joined medicare & need to find a good reliable provider for part D, any recommendations ? ...
A: Prepare a list of all your prescriptions, how often you take them, and the dosage. Then: A. Go to ...
|
| BCBC, Medicare A, VA health care | 10/26/2009 | John Pedit |
Q: After years with BCBS FEP and Medicare Part A, I pretty much have a handle on how they work ...
A: I have Medicare and Tricare for Life, so I have not kept up with the VA benefits. You did not ...
|
| Medicare Special Enrollment Period | 10/26/2009 | John Pedit |
Q: I did not sign up for Medicare Part B when I turned 65 because I was (am) covered by my spouse's ...
A: Not by quoting a specific law. However go to Medicare Interactive.org===keyword Part b ...
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| Medicare Special Enrollment Period | 10/26/2009 | John Pedit |
Q: I did not sign up for Medicare Part B when I turned 65 because I was (am) covered by my spouse's ...
A: Hard to understand. Two entirely different law codes are involved, Medicare and COBRA. In this ...
|
| settlement | 10/26/2009 | John Pedit |
Q: My mother received a large money settlement in one lump sum and is on disablilty, medicare, and ...
A: The Medicaid regulations are different in each State. Because of that I am referring you to the ...
|
| Medicare and Cobra Insurance High Copayments | 10/23/2009 | Merry Schiff |
Q: I have Medicare part A %26 B also have United Health Insurance for Cobra. Medicare is primary and ...
A: You need to find out if your UHC COBRA plan covers your drugs and how much it covers. You are ...
|
| Difference between medicare advantage and medigap plans | 10/23/2009 | Tricia |
Q: What are the differences between medicare advantage and medigap plans?
A: I found this article on the Internet that will clearly explain the difference. Medicare Advantage ...
|
| Transfer of Medicaid Between States | 10/23/2009 | John Pedit |
Q: You responded to a question about transferring a nursing home resident from Oregon to Washington by ...
A: It all involves Medicaid. Approximately half of the money for Medicaid is Federal and the rest from ...
|
| Insurance granted then denied | 10/22/2009 | Tricia |
Q: but need you to clarify in this case please. My husband was admitted to hospital (pneumonia) in ...
A: I am not sure about hospitals in Europe as far as how hard they will try to collect. I know that ...
|
| Medicaid/Estate Recovery | 10/22/2009 | John Pedit |
Q: We live in PA and we have been caring for an uncle who has no other surviving relatives (it was only ...
A: This is too complicated to be done bt e-mail, and I am in the wrong State. So I am going to refer ...
|
| Insurance granted then denied | 10/21/2009 | Tricia |
Q: but need you to clarify in this case please. My husband was admitted to hospital (pneumonia) in ...
A: You probably should have not dropped your insurance carrier until after your appeals trying to get ...
|
| Medicare HMO state transfer | 10/20/2009 | John Pedit |
Q: My father is going on day 64 in the hospital after a post-operative perforated bowel which led to ...
A: Too complicated to be done by e-mail. So, I am referring you to my counterpart in PA. Call ...
|
| Dental office "not in network" | 10/18/2009 | Tricia |
Q: I walked in a dental office with a toothache, and asked them specifically if they are they are in my ...
A: I would definitely fight them on this........you will probably have to pay something but if you call ...
|
| Denied claim | 10/16/2009 | Tricia |
Q: If is a claim denied, would I have to pay "list price" of a procedure or the insurance company's ...
A: If your insurance carrier denies a procedure and you either know a negotiated rate or if you are ...
|
| Help please | 10/16/2009 | John Pedit |
Q: I am upset. While visiting my family in CA, I took my 5yr old triplets to the ER for upper resp. ...
A: Because State money is used for approximately half of the Medicare funds in each State, the ...
|
| Denied claim | 10/15/2009 | Tricia |
Q: If is a claim denied, would I have to pay "list price" of a procedure or the insurance company's ...
A: It depends-------your Explanation of Benefits that showed that your claim was denied will show you ...
|
| MSP coverage | 10/15/2009 | John Pedit |
Q: I take care of my brother who is disabled and I claim him on my taxes as a dependant. Right now, he ...
A: Your way may work out, but there may be a better way. I am referring you to our program(SHIP} in ...
|
| Would I qualify, if so for bariatric surgery in FL? | 10/14/2009 | John Pedit |
Q: I've read through what I could understand of floridas medicare website/s. I can't seem to figure out ...
A: Go to the State web site=====keyword and click on MEDICAID=====find and scroll on Programs. Also go ...
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| Would I qualify, if so for bariatric surgery in FL? | 10/14/2009 | John Pedit |
Q: I've read through what I could understand of floridas medicare website/s. I can't seem to figure out ...
A: The person to ask is the doctor. He is the one that assigns the claim payment code. If he says it ...
|
| excess stomach skin | 10/13/2009 | Tricia |
Q: I went to my medical doctor and he felt that I should get my extra skin removed from my stomach. He ...
A: Most insurance companies do not pay for cosmetic procedures. They only have to pay for medically ...
|
| Submitting Bills to Medicare | 10/13/2009 | Merry Schiff |
Q: My son is a Medicare patient of a psychologist who has not agreed to become a Medicare provider. He ...
A: David..She had better know how to do it. It is a Federal law that she must submit the claim. And she ...
|
| Submitting Bills to Medicare | 10/13/2009 | Merry Schiff |
Q: My son is a Medicare patient of a psychologist who has not agreed to become a Medicare provider. He ...
A: If the psychologist has opted out of Medicare, she must inform the patient that for two years, ...
|
| Medicare | 10/9/2009 | John Pedit |
Q: My parents currently have MedicareComplete H0543 - 084, an HMO plan. My Mom was diagnosed with gall ...
A: The trouble with an HMO, you have to get permission to go out of network. Without that you have to ...
|
| Help! My doctor is a crook! | 10/7/2009 | Tricia |
Q: I called around for a psychiatrist who took my ins which is SAG Blue Cross. This doctor said that he ...
A: I think I would call the Dr and ask him about the bill. Advise him that he told you that it was ...
|
| Lapband Surgery | 10/7/2009 | Tricia |
Q: I am 5 foot 6 I weigh 340 pounds I have been diagnosed with sleep apnea and I am hypertensive. Will ...
A: Many insurance carriers do now pay for some type of weight surgery but all have specific guidelines. ...
|
| medicare and hmo coverage | 10/6/2009 | Merry Schiff |
Q: As of 01/01/2010, I will be covered under medicare. I would like to know that since I also have ...
A: There is no reason to have an HMO as secondary coverage..in fact, they probably would not let you. ...
|
| medicaid | 10/6/2009 | Adelaide Rose |
Q: I am divorced and provide health insurance coverage for my children through my employer. My ex has ...
A: Bryan, If your children are covered under your insurance, then your insurance is primary. Mediaid ...
|
| post op co payments | 10/6/2009 | John Pedit |
Q: I am 78 years (diabetic) old and I am having cataracts removed. The surgeon recommended that I have ...
A: The question is when you were told they were not covered. With Medicare the doctor is required to ...
|
| medical billing | 10/6/2009 | Merry Schiff |
Q: Last month I had a medical procedure done (colonoscopy). My deductible with Blue Shield was fully ...
A: I'll bet that they coded it as a screening colonoscopy. Call them and ask them to send you a copy of ...
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