AboutJohn Pedit Expertise Am an expert on Medicare, Medicare HMOs, and Medicare supplemental insurance. Also have extensive knowledge of Medicare especially in Mich. Have knowledge of COBRA and the Portability Act
Experience
Past/Present clients Council about 300 persons yearly and do many presentations on Medicare
Question My doctor wants me to take the Recast osteoporosis therapy. It is an outpatient treatment given by IV. I am a 94 year old male. My hospital is not sure if I am covered by Medicare since this procedure is usually done on females. Am I covered?
Thanks, Julius
Answer Hi Julius
Sorry I do not know the answer, it is outside of my expertise.
However, unlike commercial insurance where it is the responsibility of the patient to know if it is covered, it the doctor accepts assignment with Medicare, it is the responsibility of the provider to know if it is covered. They are then supposed to inform you that it is not covered and have you sign an ABN(Advance beneficiary notice) where you agree to pay for it if Medicare does not cover the procedure.
