Medicare, Medicaid, Insurance, HMO problems - Health Care: UK - Health/Fitness

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About Merry Schiff
(Top Expert on this page)

Expertise
I am very familar with Medicare and general insurance questions. I can answer general questions about HMO's.

Experience
I have been in the medical billing industry for 50 years. I have helped develop software for this industry. I am a consultant to billers and the medical profession.

Organizations
I am the Executive Director of NEBA, a medical billing organization with nearly 1000 members.

Education/Credentials
I have been teaching medical billing for many years as well as being a published author with Pearson Education. One book on medical billing (nearly 800 pages) and one on HIPAA.

You are here: Experts > Health/Fitness > Health Care: UK > Medicare, Medicaid, Insurance, HMO problems

Questions Answered By Expert Merry Schiff
In Category Medicare, Medicaid, Insurance, HMO problems

Subject	Date Asked

Offered Medicare B	11/11/2009
Q: I have United Health Care PPO insurance through my husbands work and have been approved for SSDI and ... A: All of this depends on how many employees your company has. You cannot have Medicare Part B until ...
Cobra/Medicare Part A	11/5/2009
Q: Husband under 65 has Medicare part A only through disability, has a retirement group policy through ... A: http://onque.com/tips/cobraandmedicare.html I really cannot comment as this is too complicated for ...
medicare & hmo's & fee for service plan	10/30/2009
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 ...
Medicare and Cobra Insurance High Copayments	10/23/2009
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 ...
Submitting Bills to Medicare	10/13/2009
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
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 and hmo coverage	10/6/2009
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. ...
medical billing	10/6/2009
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 ...
What hospital can I use?	10/4/2009
Q: I have retired to live in Thailand due to the fact that my spouse is Thai and for us to live ... A: But Part A only covers hospital fees. That does not include any services of the doctors,or so many ...
What hospital can I use?	10/4/2009
Q: I have retired to live in Thailand due to the fact that my spouse is Thai and for us to live ... A: So my question is..how do you get your ss checks..Are they mailed to you in Thailand or are they ...
What hospital can I use?	10/3/2009
Q: I have retired to live in Thailand due to the fact that my spouse is Thai and for us to live ... A: If you had enough working quarters in the Medicare system, you can still get Medicare but you will ...
Primary insurance Plus Medicaid	9/28/2009
Q: I was denied service at my OB office because I have a primary insurance and Medicaid. My OB does ... A: The doctor does not accept you as a Medicaid patient and can just bill your primary insurance. You ...
pre-existing condition	9/27/2009
Q: I live in Pennsylvania and had planned on retiring at 55 (two years from now. I would need to ... A: I am so sorry for the news about your health. You may find it nearly impossible to get insurance ...
breast reduction	9/27/2009
Q: I am being told thta Medicare does not pre-approve breast reductions(in Nevada)and that I need to ... A: Are you talking about Medicaid? Medicare is generally for the older population and does not require ...
Medicare reimb rate , COB with GHP paying secondary	9/25/2009
Q: I sent a more complex version of this question to John P, who declined Am sending a more succinct ... A: If a provider is participating with Medicare, in other words, has a contract to accept Medicare ...
Medicare reimb rate , COB with GHP paying secondary	9/24/2009
Q: I sent a more complex version of this question to John P, who declined Am sending a more succinct ... A: Medicare will pay 80% of the allowed amount and the GHP will pay the 20%of the allowed amount that ...
health care coverage for my daughter	9/1/2009
Q: My daughter was being covered by my ex-husband on his insurance. He lost his job in December of ... A: Tough question. Is the coverage for your daughter part of a divorce settlement. How old is she? How ...
Medicare B special enrollment period	9/1/2009
Q: "your spouse or family member stops working, or the date the Group Health Plan (GHP) or Large Group ... A: Interesting question. Does your group have more than 20 employees? If so, did he ever sign up for ...
Breast Reduction	9/1/2009
Q: I was wondering why Medicare/Medicaid denied my request for breast reduction. I have severe back and ... A: I have no idea. There is no authorization needed for this unless you are in a Medicare Advantage ...
Insurance Claim rejected- Pre existing condition	8/27/2009
Q: here is the detail of my case: i took my insurance from PSI insurance(www.psiservice.com) on 24th ... A: Usually insurance is effective on the first of the month so it is strange to me that this would ...
Reply	8/24/2009
Q: Your replied to the following question below and asked if I had recieved a bill from the medical ... A: First of all..I would do everything in writing. Do not have a phone conversation with anyone as you ...
electric scooter/medicare	8/22/2009
Q: My mother-in-law is in a nursing home in New York, is 88 years old and has advancing Parkinson's and ... A: For your second issue..Your provider had to have a NPI number in order to bill Medicare. You ...
Medically Needy with share of Cost	8/7/2009
Q: I can never reach the Dept of Health. I hope you can clarify for me. I have share of cost, I am not ... A: You have to pay the first $500 which supposedly is your share of cost (PER MONTH). The provider ...
Medicare	7/30/2009
Q: I have a family member who has a question about Medicare Presciption Plan Part D. She is going to ... A: These stores do not carry all generics and if the dosage that your friend must take is more than one ...
private insurance and Medicaid	7/27/2009
Q: I am a divorced mother of a 2 year old. My ex husband holds the insurance policy for himself and our ... A: Medicaid is the payer of last resort. You could have him under yours and use Medicaid as secondary ...
private insurance and Medicaid	7/27/2009
Q: I am a divorced mother of a 2 year old. My ex husband holds the insurance policy for himself and our ... A: I cannot tell you what Medicaid will cover as this is a state plan and the benefits differ aside ...
denial of payment by HIP	6/29/2009
Q: My family lives in NYC, my mom is 70, she and my Dad were in Atlantic City, NJ for a few days, in a ... A: Your mom evidently has Medicare but she is part of a Medicare Advantage Program which is part of ...
medicare	6/27/2009
Q: I am 59 and retired two years ago. I will receive my health benefits until I am age 62. Upon age 62 ... A: All of this depends on the amount of employees at your company (Really!!) and please do not confuse ...
Secure Horizon	6/26/2009
Q: Moms has a HMO and is married to my father who is in very good health. They were both living with me ... A: If the HMO that your mom has is also doing business in Sacramento then all you have to do is ...
Preventative medical care claim	6/16/2009
Q: I have a health savings account high deductible medical plan that says it covers 100% of the cost of ... A: It does not sound to me that this is preventative. I do not understad why it wasn't covered with the ...
Medicaid for Daughter	6/10/2009
Q: Currently, we are living in Florida. Becuase of the economic crisis we are moving to NY to both be ... A: My heart is with you. Thank goodness for good family. you will need to reapply in NY but see wht you ...
Ins/Medicare related	6/9/2009
Q: My question is complex. My husband is disabled & has Medicare. I still work & he is covered under ... A: Clearer now..This is what i would do. you need to write the physician but write and send me the ...
Taking insurance	6/4/2009
Q: I am a nutritionist professional. I do counseling one on one with individuals. I currently do not ... A: You must sign up with the insurance company before she will be covered assuming she has some kind of ...
dental	5/28/2009
Q: i receive medicaide as well as medicare and i broke my tooth i went to the dentist and the ... A: Medicare does not cover dental work and Medicaid will not pay for what you need except a possible ...
Medicaid Share of Cost	5/27/2009
Q: I saw a post here regarding the same issue I am having as another individual. I am on SSDI, and have ... A: Medicare will not kick in til you re 65. Social Security can kick in earlier. If you have been on ...
HMO V LAPBAND OR BARIATRIC SURGERY	5/15/2009
Q: im confused about what covered as far as the lapband surgery, or bariatric surgery. I was told by my ... A: I have gone on many tirades about insurance companies also. But I cannot tell you what your HMO will ...
Transfering Medicare benefits between states	5/10/2009
Q: I'm pregnant and planning on moving from Arizona to Colorado before I have the baby in September. ... A: You are a bit confused about what you have. You do not have Medicare, but you have the AZ "brand" of ...
Medicaid for an unborn child with birth defect	4/30/2009
Q: My daughter is 22 weeks pregnant and her baby has been diagnosed with bilateral club feet. She and ... A: Medicaid has monthly income limits but most states have special services for children with special ...
Medicare Part B	4/27/2009
Q: Two questions: 1. Was NJ disabled person (since 2002) that qualified for Medicare Part A and ... A: Someone has made a mistake. I would call the lab and explain that Aetna is primary and not Medicare. ...
Medicare Part B	4/27/2009
Q: Two questions: 1. Was NJ disabled person (since 2002) that qualified for Medicare Part A and ... A: So did you take Medicare when it was offered? Is the Aetna insurance plan with a large group? You do ...
medicare and aetna	4/26/2009
Q: am 61 yrs old, retired from NYC Dept of Ed...on disability...govt just sent me Medicare info to join ... A: I am a bit confused. Have you been on SSDI for 2 years and now eligible for Medicare? If you have ...
time limit medicare can request refund in CA	4/24/2009
Q: I read that a reimbursement request for overpayment of a claim shall not be made, unless a written ... A: Are you saying that Medicare paid the provider too much money? Rarely will you see an overpayment ...
Deductible for medicaid	4/22/2009
Q: My grandaughter has been diagnosed with a brain tumor and needs an operaton asap. She is on SSI, ... A: This sounds to me like a share of cost which would be what you would have to pay per month before ...
changing medicare from California to Texas	4/17/2009
Q: My mother is law is getting ready to move from California to Texas permanently. We need to get in ... A: If she is in Original Medicare (no Medicare Advantage)then just call Medicare and change the ...
Should I take Medicare as secondary?	4/14/2009
Q: I am on disability and have been offered medicare. I have a PPO through my husband's job which is a ... A: Are you on SSDI? If so and you do not have ESRD then you have to wait two years for Medicare to kick ...
Medicare	4/3/2009
Q: I have a son with a degenerative metabolic disorder that the treatment is experimental. My ... A: Patty..No insurance will cover treatment that is experimental. Look at this link. ...
Inheritence and medical bills	3/31/2009
Q: My mother is 83 and still in good health, living with my sister. She wants to disperse her savings ... A: You definitely need an elder care attorney for this. I believe the amount she can give each person ...
Medicaid Assets	3/27/2009
Q: I have joint accounts for 7 years with my mother on a checking, money market and CD. Now she is in ... A: Absolutely but you need to check with an elder law attorney for the laws in your state. You will ...
resident:Fla Injuried & Treated S.C.	3/11/2009
Q: My 88 year old mother, a home owner in Fla, while visiting my sister my in S Carolina, fell, broke ... A: Does your Mother have Medicare? You mention Medicaid..Does she have Medicare and Medicaid? Is she in ...
my daughter needs a neurologist now	3/10/2009
Q: she needs a neurologist in the orlando area right away and she has that florida (share of cost) ... A: doctors do not understand share of cost. Once she has met the monthly share of cost, she is ...
my daughter needs a neurologist now	3/10/2009
Q: she needs a neurologist in the orlando area right away and she has that florida (share of cost) ... A: Share of cost is money that you must pay out of pocket before a dr can bill and collect from ...
medicare vs private insurance	2/28/2009
Q: My father in law who is 81 had a salesman from SCAN health insurance company visit him about a year ... A: Your father in law cannot drop out of the HMO except during the enrollment period which has passed. ...
Billing Medicare for Auto Accident	2/27/2009
Q: A medicare patient has a car accident her car insurance says Medicare is Primary and must be billed ... A: Medicare is never primary when there is medical for the auto accident. Medicare will pay until you ...
Even if elligible for Medicare, can I stay on current HMO?	2/25/2009
Q: I am now eligible for Medicare due to a disability, but I would like to remain on my husband's HMO ... A: If you are already receiving Social Security Disability benefits, you will automatically be enrolled ...
Health Insurance Coverage	2/23/2009
Q: Husband got laid off in Nov. Our health insurance coverage for our family through him ended Nov. ... A: I am not sure about all of your questions. But immediately, you need to see about COBRA under his ...
medicare non-participating provider	2/22/2009
Q: I believe I did opt out because I look for myself as a provider and I am not listed. A: I would suggest that you call Medicare. http://www.aapsonline.org/medicare/optout.htm If you opt ...
medicare versus present inurance	2/21/2009
Q: I will turn 65 in three months. I am not eligible for Medicare on my own as I have insufficient ... A: Usually, once you are 65, you must sign on to Medicare Part B even though you are in an HMO. But ...
affordable healthcare in arizona	2/12/2009
Q: my name is John. I am 47 (almost 48) and have been on Social Security Disibility (SSDI) since 1999. ... A: Call these people first. It is ALL FREE. they will advise you and they do not sell insurance. Every ...
affordable healthcare in arizona	2/12/2009
Q: my name is John. I am 47 (almost 48) and have been on Social Security Disibility (SSDI) since 1999. ... A: John,,first of all..with your Medicare, you should pick up a secondary policy like AARP and then, if ...
my heart transplant	2/10/2009
Q: I had a heart transplant 8 years ago. I am 57 ys old. Is there any way I can get some kind of ... A: .You sound as though you are really having problems with me medical care. I would contact a social ...
Newborn coverage	2/9/2009
Q: The wife and I just had a son. We've been paying for her health insurance privately (she can't work ... A: What they are telling you makes sense. The baby is covered under the policy of the mother. And, ...
Non participating provider billing and secondary insurance	1/28/2009
Q: One of my physicians prefers not to get involved with Medicare and instead lowers his fees for ... A: Has your physician ever had a Medicare number. If so, he would have to opt out of Medicare if he ...
Medicare	1/19/2009
Q: I lost my job in October after being there 9 1/2 years. I will be 61 in April. Currently I am ... A: Sharon..You can relax. You need to sign up for Medicare when you are eligible. You can sign up three ...
moving medicare from one state to another	1/18/2009
Q: We want to move our uncle from NJ to NE. He has alzheimers & it is starting to get worse. We dont ... A: If your uncle has Original Medicare and not an HMO, the insurance will travel with him. If he has a ...
once i'm on medicare can i drop current individual health insurance that i'm buying each month	1/15/2009
Q: I am in my late 50's and unemployed for a long time, but have been buying my own individual health ... A: You should drop your health insurance of course and take Medicare and if you don't, you will be ...
Medicare Opt Out Letter	1/14/2009
Q: Our practice (Tax ID) has never been Medicare providers or received reimbursement from Medicare. ... A: You cannot opt out if you have never been provider. But you need to get clarification from Medicare ...
Medicare/HMO	1/14/2009
Q: I am writing in regard to my grandmother. She currently had Medicare and in addition Humana Gold ... A: I am going to assume that she is in the Humana Medicare HMO. So she does not have Original Medicare. ...
Medicare plans	1/7/2009
Q: I am trying to enroll my mother in a pharmacy plan. I don't have her Medicare card with me as she ... A: there are more than just A and B. "M" means that she has Medicare Part B but that she does not have ...
On Disability moving state to state	12/31/2008
Q: I collect Disability due to permanent spine damage have Medicare Supplement Insurance in Illinois. ... A: Are you on Social Security Disability oar some other kind. I assume SSDI, right? If so, your ...
medicare and insurance	12/19/2008
Q: I am disabled and on medicare and have a Medicare advantage plan ppo w/ BCBS of oklahoma which auto ... A: You should call Medicare. If you move, you can change anytime as long as your plan is not available ...
Abortion	12/14/2008
Q: i need to plan an abortion without my parents knowing. im under 18 ad i have my medicaid ad birth ... A: Some states have laws that they must contact your parents. Why don't you go to Planned Parenthood ...
medicare only vs. supplemental insurance	12/12/2008
Q: My 92 yr. old mother has Health Net Seniority Plus, 2009 premium will be $96/mo.. She lives in an ... A: I cannot imagine why someone told you this. Medicare only will give you the choice of doctors but ...
Medicare denial letter	12/2/2008
Q: I do billing for Chiropractors here in southern California. I have a doctor that is not ... A: I am not taking questions here from offices for billing but I will tell you to call Palmetto as you ...
Moving from NY with Medicade and Medicare to SC	11/30/2008
Q: What would the procedure be if one move from NY to SC and have medicade/medicare be like? Please ... A: You need to reapply for Medicaid in SC. And of course you need to let Medicare know of your new ...
Medicare Advantage denied claims	11/25/2008
Q: I understood if a charge is allowable by Medicare that the Medicare advantage plans are required to ... A: Definitely call the Dept of Insurance if that is who manages your HMO's in the area. I am curious, ...
Medicare Advantage denied claims	11/25/2008
Q: I understood if a charge is allowable by Medicare that the Medicare advantage plans are required to ... A: Have you called the Advantage Plan? You would have to go through the appeals process for your Plan. ...
No Copay For Medicare / Social Security	11/23/2008
Q: My question is more of a complaint/Suggestion/Act of reasoning and may turn out to be lobbied. I am ... A: There is a Federal agency that can help you at no cost. the number in TX 1-800-252-9240 and they ...
No Copay For Medicare / Social Security	11/23/2008
Q: My question is more of a complaint/Suggestion/Act of reasoning and may turn out to be lobbied. I am ... A: Secure Horizons is a Medicare HMO. Medicare has different drug plans and you may qualify for "Extra ...
No Copay For Medicare / Social Security	11/23/2008
Q: My question is more of a complaint/Suggestion/Act of reasoning and may turn out to be lobbied. I am ... A: I do understand but you need to know that Medicare eligibility has nothing to do with income. If you ...
SSD,Medicare,Supplemental In. and my Ins coverage at work	11/21/2008
Q: My husband is 55 and is drawing SSD and has Medicare Part A and B. He is totally disabled. I am 49 ... A: Because he is on SSD, he is not eligible for all the benefits of Medigap that those over 65 are ...
Birth certificate for Medicare Enrolment	11/20/2008
Q: I was asked to produce my birth certificate for my medicare enrollment. I was born in India, but I ... A: Very interesting question and I am not sure. But, call the Medicare office and arrange for an ...
I am pregnant and have insurance question	11/19/2008
Q: I am 17 years old, pregnant and I am due March 13th, 2009. My doctor is asking for almost $700 ... A: If you meet the income requirements for Medicaid, Aetna will pay their portion and Medicaid will ...
turning 65 employeed with less than 20 people	11/17/2008
Q: My co-working turned 65 this year 2008. They went to ss when they turned 65 and only received part A ... A: The information that your co-worker is getting is correct. She must get Medicare Part A and Part B. ...
Depenant Health insurance	11/16/2008
Q: We live in MA our 17 year old daughter moved out this summer and quit High School. We just found ... A: I do not know the MA rules. You would have to talk to your insurance company or read your insurance ...
medicaid/exercise	11/12/2008
Q: I have medicaid and medicare. I recently had a heart attack and less than two years ago open heart ... A: Medicare will pay for cardiac rehab if it is medically necessary. Since Medicare is your primary ...
car accident - medicare and helathnet ruby 1 reimbursement	11/11/2008
Q: my mother's medical bills have met and will most likely exceed all auto coverages involved. if ... A: It is not about negotiating and no Medicare does not. Is she in a HMO or is she have Original ...
Returning to a medigap policy	11/9/2008
Q: I presently have a medigap policy. if I change to an Advantage policy and then after a time for ... A: You can only change during specific periods of time and only once a year. What is the problem that ...
medi/medi patient	11/7/2008
Q: would pick up what the other would not and it was against the law to try and bill the balance to the ... A: If the physician accepts the patient as a Medi/Medi patient then he or she cannot bill the patient ...
SSD & Medicare	11/5/2008
Q: My husband was injured at his job of 30 yrs & as a result of going to the companies workman comp ... A: Joni..Humana is a Medicare HMO. If he is on Social Security Disability, he should get Medicare after ...
SSD and Medicare	11/4/2008
Q: I have been carrying my husband on my health insurance but now need to drop him from my insurance. ... A: Between Medicare and the secondary you should be fine though because he is under 65, you will not ...
SSD and Medicare	11/1/2008
Q: I have been carrying my husband on my health insurance but now need to drop him from my insurance. ... A: Medicare will become his primary insurance and you should get a secondary and perhaps a drug plan ...
BCBC BS	10/29/2008
Q: Here's myMy wife has been disabled for many years now and has been collecting SS disability for ... A: do not understand why they denied the claim for the colonoscopy though it was coded as routine, it ...
Medicare and Cigma	10/29/2008
Q: I am researching for my parents who have medicare and Cigma insurance provided by the State of ... A: David..Contact an elder care attorney. They are the best ones to advise you. Where are you in CA? ...
Medicare and Cigma	10/28/2008
Q: I am researching for my parents who have medicare and Cigma insurance provided by the State of ... A: Are you telling me that they have original Medicare and CIGNA as a supplemental to Medicare. If so, ...
MEDICARE/WELLCARE	10/26/2008
Q: I PRESENTLY HAVE WELLCARE WHICH TAKES MY MEDICARE BENEFITS AND MY COPAYS ARE VERY ... A: I am sorry but I cannot recommend any plan. You essentially have to think of yourself as not having ...
Medicare C	10/18/2008
Q: My mother lives in Atlanta Ga. someone continues to call her re: the above. I am unclear as to why ... A: The sales people are NOT allowed to solicit. She does not need an HMO. Actually if she is happy with ...
medicaid	10/18/2008
Q: can a doctor refuse to re-bill medicaid (in North Carolina)because you have not received your card ... A: Here is the story. Did your doctor take you as a Medicaid patient when he or she saw you for ...
Helping My Father Change from Sr. Dimensions to Medicare in Nevada	10/15/2008
Q: My father is 81 years old and would like to switch from Sr. Dimensions to traditional Medicare. We ... A: Great news Christine..Your dad can switch once during the Annual Coordinated Election Period which ...
Transfering medicaid from one nursing home to another in another state	10/15/2008
Q: The nursing home my relative is presentlt in(3 yrs.)is being closed by state of Mich.They are in ... A: You may very well have a residency problem. You are smart that you are questioning this. If you will ...
Does Kaiser have an obligation to provide an expert surgeon?	10/13/2008
Q: My daughter has to have arthroscopic hip surgery to repair FAI. She is only 12. This is an ... A: Interesting question. I am in CA also so I am familiar with Kaiser. I would talk to someone at ...
moving from OH to CA Medicare HMO Coverage	10/10/2008
Q: My father recently had a stroke (1 month ago) and is currently in a short term stay in Skill Nursing ... A: You need to contact AARP and see if they have coverage in the area that your father will be moving ...
medicare secondary insurance	10/8/2008
Q: I have medicare in Texas thru Trailblazer as my seoncdary insurance. I am trying to find out if ... A: no..Medicare will pay up to their allowables on each procedure. Does your primary insurance pay 85% ...
out of network billing for emergency surgery	10/8/2008
Q: My boyfriend was in a motorcycle accident, was taken to UCI Med center with a broken back. Surgery ... A: Kaiser will have to pay. The physician who treated him has to document that he could not be ...
coordination between medicare & medicaid	10/7/2008
Q: My father in law is currently enrolled in a ppo plan and is also on medicaid. He is in a nursing ... A: I FIL is in a Medicare Advantage Program. If you go to Original Medicare, you have a choice of ...
QMB BENEFITS In FLORIDA	10/2/2008
Q: I was approved for Qmb 8/08 and Have Medicare as of 08/08.I live in Florida While visiting my sister ... A: Medicaid is state specific and you are covered by Medicaid in FL and not in KY. Since this was an ...
medicare HMO non contracted plans	9/29/2008
Q: If a patient has a Medicare HMO (ie. humana)that is not contracted with the hospital, is there still ... A: The payment would have to be made by the HMO to the hospital if it was a true emergency. They do not ...
Medicaid in PA	9/23/2008
Q: I was widowed 3 years ago. I am juvenile diabetic and extremely brittle. I was on the insulin pump ... A: Medicaid is determined by income and you may be over the limit for your state. I would definitely ...
Unjustified medical nill	9/23/2008
Q: I am currently billed $243 for an E.R. visit, and I'm wondering if there is a way for me to cancel ... A: Actually, no. The fees can vary. You were obviously charged for a very limited visit. The person who ...
Unjustified medical nill	9/22/2008
Q: I am currently billed $243 for an E.R. visit, and I'm wondering if there is a way for me to cancel ... A: When you signed the paperwork at the hospital, you said that you would pay the bill. The dr charged ...
Medicare Part A	9/22/2008
Q: .he broke his femur and fractured his hip...he has to have surgery today and it will be only an ... A: Medicare Part A and B come into play here. I assume that he has Original Medicare and not an HMO. If ...
mirena IUD	9/21/2008
Q: my doctor is ordering this IUD for me and said it may not be covered by medicare but said ablation ... A: I agree with you..but Medicare and other plans only pay for what is medically necessary and ...I ...
What is the medicare reimbursement for weight loss surgery	9/19/2008
Q: I have just bought a new insurance policy because the health insurance that I have through my ... A: I cannot give you an answer. Medicare reimburses according to geographical location. You can be ...
parents moving - need help/advice on medical coverage issues	9/5/2008
Q: So glad something like this exists. We (siblings) are planning for my parents to move from NV to ... A: Sounds like a Medicare Advantage Program. If this is not available in San Diego, then your parents ...
Unautherised Sign-on to HMO	9/3/2008
Q: I have just discovered today that I have HMO health coverage. I did not sign on to HMO at any time. ... A: Because Medi-Cal pays your Medicare premium, you have no choice whether you will be in an HMO or ...
what do I do first?	8/30/2008
Q: My husband must have a triple bypass and a heart valve replacement immediately. He is 79 years old. ... A: Freedom Savings is a Medicare HMO. You need to call them but if obviously this is a medically ...
How does a provider submit claim	8/28/2008
Q: The email from Steve is my exact question. My doctor is not a Medicare provider and would like info ... A: Sorry, if your doctor is not a Medicare provider, none of the services that the doctor provides will ...
medicaid/ medicare	8/27/2008
Q: I am 55 and 100%disabled and recieve social securety dissability however I do not recieve medicare ... A: During this waiting period SSDI benefits cannot be paid. It is important to note that this waiting ...
medicare ? Medicaid and SSI ? help	8/21/2008
Q: My son was 9 years old when hit by a semi . this resulted with him having a brain injury and ... A: I sure that if he had SSDI for two year that he would be eligible for Medicare but your son is on ...
Ethical Issue?	8/21/2008
Q: I hope you can help me. I've been receiving treatment from a PT for a few months now for foot ... A: If you are out of network, you are treated as a private patient and they can bill you whatever they ...
Medicaid, Pregnancy and Travel...HELP??	8/19/2008
Q: Im going to try to make a long story/question short...I recently got married bc my husband enlisted ... A: Medicaid does not have pre-existing conditions so if you qualify for Medicaid a pregnancy would be ...
Secondary Medicaid problems	8/18/2008
Q: I live in Texas and I am pregnant and I have private insurance but the closest OB/GYN in my network ... A: The problem is that your primary coverage is with your primary insurance company and you are not in ...
denied medicare claim	8/17/2008
Q: My mother was discharged from an nursing home too soon. We had to take her back to the emergency ... A: I would call Medicare and get it straightened out as they are the ones that denied the claim. You ...
Eye Exams	8/12/2008
Q: I have Medicare. In December 2003, I had an eye exam for glasses at Walmart. The exam was paid for ... A: Medicare has always paid for the part of the exam that does not include the refraction. They have ...
AARP{	8/6/2008
Q: My mother (82) has Medicaire and a supplemental insurance which she has used for years without a ... A: I have AARP myself and have never had a problem at all. If she has a "J" plan with her other ...
Psychologist submitting Medicare claims	8/6/2008
Q: Appreciate your help. I am a virtual assistant and have agreed to help my client submit invoices to ... A: You asked me: << So, any information you can give me should be relevant to Philadelphia.>> You did ...
Psychologist submitting Medicare claims	8/5/2008
Q: Appreciate your help. I am a virtual assistant and have agreed to help my client submit invoices to ... A: I am going to try to be very kind (because I am) but I will be blunt. If you have never done medical ...
Coverage by medicare for TMJ	8/5/2008
Q: I am having sever problems which has not been diagonsed as TMJ, but am 100 % sure that this is what ... A: Wow..sounds as though your plate is full. Medicare does not pay for TMJ, but will pay for your tests ...
out of state surgery	8/3/2008
Q: I live in Idaho and I need back surgery but there are no facilities that cover the non-invasive ... A: Medicare pays for medically necessary procedures but they also have to be an approved procedure ...
Varicose Viens- Why are they conisdered cosmetic	8/1/2008
Q: I have been dealing with a vein in my leg for 10 years. Recently I have developed heaviness and ... A: It is really up the surgeon to talk to the insurance company and to justify why you need this ...
Confused(Medicaid vs Healthease-HMO)	7/30/2008
Q: I have a 2month old daughter which is currently on Medicaid and I've been offered the opportunity to ... A: All Medicaid recipients will at some point have to chose an HMO or have one assigned. I cannot give ...
Varicose Viens- Why are they conisdered cosmetic	7/29/2008
Q: I have been dealing with a vein in my leg for 10 years. Recently I have developed heaviness and ... A: Oh I do understand this. Are you in an HMO. That what it sounds like. You do frequently have to go ...
Share of Cost	7/28/2008
Q: I am asking this question for a dear friend. Her husband is on medicaid and she was told they make ... A: You may be confusing Medicare and Medicaid. I think you mean "to be on medicaid for medical ...
Medicare	7/26/2008
Q: I am a licensed RN in the State Of Florida. My father recently had a very debilitating stroke. I ... A: No, you cannot care for your father and bill Medicare. First of all, Medicare specifically states ...
Question	7/25/2008
Q: My father is from Texas and he has Medicare and Medicaid and does not have enough to pay for ... A: Medicare does not pay for routine dental care. I would call your Medicaid worker and see if you can ...
Medicare effective dates, etc...	7/25/2008
Q: My mother was recently diagnosed with lymphoma. Instead of being treated at a in network facility ... A: Your questions are excellent and I do not have enough information to answer all of them. If she ...
Medicare supplemental insurance	7/21/2008
Q: I want to first thank you for your recommendations back in July 5, 08. I wrote to you regarding my ... A: These should be fine especially since they billed sometimes and forgot to bill the other times. SO, ...
Medicare supplemental insurance	7/21/2008
Q: I want to first thank you for your recommendations back in July 5, 08. I wrote to you regarding my ... A: You should not have to pay. I would get a letter from the insurance company telling you that you ...
Tummy tucks	7/20/2008
Q: I have had 2c-section and i keep working out but my stomach never go down now i have 3 children i ... A: You sound like you have tried what you can to help yourself. But with abdominal surgery, sometimes ...
Oral Surgeon / Florida Medicare	7/18/2008
Q: Polk County, Florida - Are there any oral surgeons that provide services for Medicare patients (at a ... A: Medicare does not cover any dental work. I think you must mean Medicaid. I would call the local ...
balance billing	7/18/2008
Q: went to ER at local hospital. was admitted and was apparently seen and treated by out of network dr ... A: I get this question more than any other in my consulting practice. You went to the hospital that was ...
Medicare	7/16/2008
Q: my 94-year old mother will need to move into a family member's home in another county in Florida - ... A: I am going to assume that your mother is an Advantage program (Medicare HMO) If that is the case, ...
Medicare co-pay	7/15/2008
Q: My co-pay for specialist office visits is $30.00. A specialist's office informed me that I have a ... A: I feel the way you do...go after them, but it will be useless. Just be glad that they are not ...
Medicare co-pay	7/11/2008
Q: My co-pay for specialist office visits is $30.00. A specialist's office informed me that I have a ... A: I looked up Keystone 65 which is a Blue Cross Medicare HMO. Here is the link for benefits ...
needing help !	7/10/2008
Q: Let me introduce myself, my name is Thomas Briones and I am a Certified Hyperbaric Technician. I ... A: No insurance company will pay for some thing that they feel is not medically unnecessary so you will ...
coverage	7/9/2008
Q: the questions is if work men comp buys some one out that was hurt and they covered back surgery ... A: Here is an interesting link. http://www.lir.msu.edu/wcc/Medicare/documents/Dealing%20Medicare.pdf I ...
medicare supplemental insurance questions	7/5/2008
Q: My dad passed away on 3/07 at age 66 with pancreatic cancer. He was fully insured with medicare A&B ... A: http://www.state.nj.us/health/senior/ship.shtml This is the very best place to go. They know NJ law ...
medicare supplemental insurance questions	7/4/2008
Q: My dad passed away on 3/07 at age 66 with pancreatic cancer. He was fully insured with medicare A&B ... A: I have some questions..Was the Bankers Life a Medigap policy? Was the oncologist a Medicare ...
unpaid maternity bill	7/3/2008
Q: My daughter was born a year ago and we had all the maternity expenses covered through my insurance ... A: I would find out exactly the information needed from the provider and be sure that they do it. I ...
my parents	7/2/2008
Q: I have moved my parents to my home because they can not care for themselves anymore. Can I provide ... A: .I have an elder parent so I well understand. Medicare does not pay for custodial care so the answer ...
billing insurance companies	7/2/2008
Q: I'm planning to go into private practice when I get licensure as a mental health counselor. How do I ... A: You need to contact Medicaid and ask them about getting a provider number to bill the Medicaid ...
Medicaid	7/1/2008
Q: My friend was in a horrible accident in Dec. 2007 in Texas. Medicaid only approved him for ... A: I assume that his disability brings in too much money for him to qualify for Medicaid. I would ...
medicare insurance	6/27/2008
Q: I turn 65 9/29/08. I am covered by medical insurance thru wife's employment...cost to her ... A: Yes..call Medicare and enroll in Part A as it is free if you have worked and have enough quarters. ...
hospital bills	6/26/2008
Q: My main problem is a medical bill left from a surgery I had in March 2008. My insurance paid the ... A: The little notes that you attach to a payment probably is not even read as the people that input ...
hmo and part D	6/26/2008
Q: I have Horizon blue cross Hmo and I am not happy with it. I am paying more now for Doctor visits ... A: You actually have an Advantage plan (Part C) and you cannot just drop it and pick up Original ...
Am I liable for daughter's newborn?	6/25/2008
Q: My daughter was 20 years when she gave birth. At that time, she was covered under our health ... A: Your doctor is handling this improperly. I would send a certified letter return receipt (doctor ...
Medicare questions	6/24/2008
Q: I'm very confused. Here's my situation: I've been covered by COBRA medical insurance since May of ... A: You can wait now for Medicare though Medicare could be your secondary. Call Medicare and ask them ...
pregnancy	6/23/2008
Q: I am an RN between jobs, without insurance, and have just discovered I am pregnant. Will I be ... A: If you are 65 or over or with certain disabilities, then Medicare may be the correct choice for you. ...
Am I liable for daughter's newborn?	6/23/2008
Q: My daughter was 20 years when she gave birth. At that time, she was covered under our health ... A: But did the hospital get paid for newborn nursery? Please find out and let me know. You need to send ...
Am I liable for daughter's newborn?	6/23/2008
Q: My daughter was 20 years when she gave birth. At that time, she was covered under our health ... A: Your husband should not be responsible for the bill but because your daughter was on your insurance, ...
Husband hospitalized in non-provider hospital (emergency)	6/21/2008
Q: We are being billed for a substantial amount that insurance did not pay, not marked off since the ... A: I would first go to your insurance company as this was an emergency so that is why I assume that ...
Medicare - age discrimination	6/20/2008
Q: I am a young person (47) on SSDI and Medicare. A Medicare doctor who accepts assignment was ... A: I am an older person and when I moved, had trouble finding a physician that accepted new Medicare ...
medicare or medicaid	6/20/2008
Q: my son born with down's syndrome he was in hospital for 7 week with hearth problems, feeding ... A: My heart goes out to you. With the excellent doctors,hopefully your little one will do well. I ...
Insurance question	6/18/2008
Q: I'm male, age 30, in the U.S (Alabama). I have private health insurance that only covers myself. ... A: Sorry to hear about your health condition. You could check with Medicaid and see if you qualify for ...
medicare approval for tummy tuck	6/16/2008
Q: I spoke with the nurse at the surgical clinic about having the skin removed from my abdominal area. ... A: Medicare pays for services that are medically necessary. It is up to your surgeon to submit a ...
Medicaid/HMO's	6/16/2008
Q: but in NY we also have a HMO with it. Now we need for the children to get check ups to go to school. ... A: Medicaid is state administered so you will have to call your Medicaid office in NC and ask them what ...
Can I get my 87 Year Old Mother on Medicaid?	6/15/2008
Q: My mother was just diagnosed with stage 4 colon cancer and if she survives the operation healing, ... A: You will notice that I often refer people to their state aging agency as they are the ones that are ...
Primary responsibility Medicare vs Private insurance	6/14/2008
Q: I have been on Medicare since I turned 65 in 2005. Medicare & a private senior supplement have been ... A: Contact HICAP in San Diego County. http://www.seniorlaw-sd.org/HICAP/index.htm They are a wonderful ...
Medicare while still working	6/12/2008
Q: I will be 65 years old on January 3, 2009. I am still working and will probably work anoter 4 or 5 ... A: If you are happy with your insurance, stick with it. You do not have to sign up for Part B ...
Switch from HMO to Medicare	6/7/2008
Q: I am confused about when and how you can switch from a Medicare Humana HMO to a traditional Medicare ... A: You may have entenuating circumstances with the situation with the person trying to get into rehab ...
Double Billing	6/6/2008
Q: We have an employee in Alabama who took her daughter for a well-baby check up and while she was ... A: It depends on your plan. It is not unusual to bill for the well child care and the office visit for ...
Issues with Share of Cost Medicaid	6/4/2008
Q: My husband and I are eligible for SOC Medicaid until June 2009. Due to our income, we have a SOC of ... A: When you make an appt with the dr, just tell them that you have Medicaid. You do not have to tell ...
medicare and SSI	5/26/2008
Q: My sister has been disabled since childhood due to severe burns over her body. She is 53. She has ... A: I am in CA also so I know Medi-Cal. I would suggest that she call her case worker at the Medi-Cal ...
ppo vs medicare	5/24/2008
Q: I have primary blue cross/blue shield of ill. PPO as my primary and Medicare part a and B secondary. ... A: I cannot give you advice about carriers. Blue Cross has different plans. I can tell you that I have ...
ppo vs medicare	5/24/2008
Q: I have primary blue cross/blue shield of ill. PPO as my primary and Medicare part a and B secondary. ... A: I can easily give you info from a personal point of view. I have Medicare as my primary carrier and ...
Dual Eligible Mental Health	5/17/2008
Q: I have medicare & medicaid insurance. Should my provider accept the Medicare approved amount for ... A: You will never be notified about Medicaid payments. And Medicare providers do not have to accept ...
Dual Eligible Mental Health	5/17/2008
Q: I have medicare & medicaid insurance. Should my provider accept the Medicare approved amount for ... A: This an be a tricky question as sometimes mental health care is carved out and paid by another ...
Insurance refuses to pay	5/13/2008
Q: I had an accident while vacationing and had to get stitches. We ended up in ER but due to a long ... A: Wow.I just helped someone else with this. Here is the story. If they were not contracted and you ...
BREAST AUGMENTATION	5/7/2008
Q: I HAVE HAD FIVE BREAST ABSCESSES AND HAVE LOST ALL BREAST TISSUE IN 1 BREAST ANS MOST OF IT IN THE ... A: Medicare will usually pay for services that Are considered medically necessary. It would Be up to ...
medicare & bypass surgery	5/4/2008
Q: i have called medicare and asked them if bypass surgery is covered, they said yes and that you must ... A: I wish I could help you. You seem to have some high medical risks so this is way beyond my expertise ...
Medicare eligibility	5/2/2008
Q: Are Medicare and SSI benefits affected by the receipt of an inheritance? If so, how? As an aside, ... A: I am sorry to hear about your accident. I would start at this website: ...
post op care	4/30/2008
Q: how do you do the insurance billing for post op care after cataract surgery. the optometrist does ... A: It depends what insurance you are billing to. You have to append a modifier to the code. Since it is ...
bill patient	4/27/2008
Q: can i send statement to a patient if his secondary insurance did not send EOB after one year but his ... A: If your doctor is in the insurance network of the second insurance company, you cannot sent a ...
tmj	4/26/2008
Q: my daughter has tmj and we live in illinois and shes on medicaid they say its not covered under ... A: TMJ is routinely not a covered service of a dental plan. Did Medicaid say that it is covered under ...
Infertility Treatment Medical Insurance Coverage	4/18/2008
Q: We are from India. My husband & I have been married for 5.5 yrs now & would love to have a baby. We ... A: .You will need to call Horizon Blue Cross and ask them if your treatment would be covered. To ...
home care medicare coverage	4/14/2008
Q: My father-in-law has suffered a stroke. Looks like he will not be able to walk or speak for sure ... A: Medicare does not pay for custodial care But because he cannot speak and is not Ambulatory I would ...
Medicare // HMO switch	4/13/2008
Q: My wife is an 85 yr. old about 2+ yrs into Alzheimer's disease. Hospitalized at this time for a ... A: I am sorry for the delay in responding. You are limited in when you can switch HMOs or go back to ...
health insurance advice	4/12/2008
Q: I'm currently a third year UC Davis Student. My health insurance is with the school, but I'm ... A: I am sorry for the delay in answering this. Medi-Cal eligibility is determined by income and ...
Medicare Billing	4/8/2008
Q: I heard a lecturer speak today who claims that she does not accept any insurance, medicare, etc. in ... A: A doctor can opt out of Medicare (lasts for 2 years) and cannot bill Medicare during this time. The ...
medical equipment supplies.	4/7/2008
Q: I am trying to get medical equipment in my home and have medicare and medicaid for insurance. I am ... A: First of all..you cannot get supplies and have them reimbursed without getting a prescription from ...
How to bill insurance	3/31/2008
Q: I am an Speech Language Pathologist and am considering going into private practice. Where can I go ... A: First of all..congratulations on your new venture. Before you do this, though, I would contact your ...
Out of Network Coverage	3/25/2008
Q: My mother wants to have an operation done by a surgeon who accepts her insurance (UPMC); however, ... A: If the hospital is out of network, they do not have a contract with the insurance company. They will ...
medicare & care plus	3/16/2008
Q: i am 65 and have not signed up for social security seeing i am still working dob 3-7-43.my question ... A: If your employer has over 20 employees you can get Medicare and it will pay as a supplemental policy ...
Medicare/Medicaid/ Nursing Home	3/14/2008
Q: My mother has been in a Nursing home since last July and has been paying for her care with her ... A: DO NOT sell the house until you talk to an attorney that specializes in trusts and elder law. PLEASE ...
Medicare/Medicaid/ Nursing Home	3/14/2008
Q: My mother has been in a Nursing home since last July and has been paying for her care with her ... A: If she is paying for the nursing home out of her personal funds, she has total control over how she ...
Procrit Shot not covered?	3/13/2008
Q: My mother was recieving a shot named Procrit that is very expensive but helps keep her anemia at a ... A: The recent National Coverage Decision (NCD) also states the following: “ESA treatment is not ...
medicare if 65 and have 401k?	3/6/2008
Q: I have a friend who is 65 and went to sign up for Medicare (already signed up for social security). ... A: Nooooo..many people who are on Medicare have 401K's. Something is not right. Medicare does not deny ...
I need help!	2/29/2008
Q: I am 19yrs old and I have Juvenile Papillomas. I have been having microlaryngoscopic surgery every 6 ... A: Medicaid eligibility is determined by assets and income. I suggest that you call your local Medicaid ...
Medicare	2/11/2008
Q: Since I am 65, have insurance through work, and I have no need to enroll in Medicare Part A or B at ... A: Since you will have proof of your coverage through your employer, you do not have to do anything, ...
Emergency Medicaid	2/11/2008
Q: I recently was admitted to the hospital because of an emergency but I do not have insurance or ... A: I would call the business office at the hospital that you were at and ask them how to apply for ...
medicare	2/10/2008
Q: I am 65 and have health insurance at work, and also collect social security. Do I have to take ... A: SEP Effective Dates If the you are currently covered under an employer group health plan (EGHP) or ...
medicare	2/9/2008
Q: I am 65 and have health insurance at work, and also collect social security. Do I have to take ... A: Special Enrollment Period is available when you did not enroll in Part B Medicare because you ...
using medicaid from one state to see specialist in another state	2/7/2008
Q: My 27 year old daughter has Congenital Myasthenia Gravis. Having had this her whole life, it is ... A: Since Medicaid is administered through the state, I would doubt this as the qualifications for ...
Medicaid	2/6/2008
Q: I am currently pregnant & was accepted by Medicaid to cover my pregnancy expenses. I was told that ... A: He will have to sign an affidavit that he has not worked. They will want to know though, how he is ...
order of billing	2/4/2008
Q: If a person has commercial insurance and (e.g.) WPS - medicare) Do I bill medicare first or ... A: You need to find out which is the primary insurance company. If the pt or spouse is still working ...
orthognathic surgery	1/30/2008
Q: I'm 35 years old and have questions regarding insurance. For the past three years I have been ... A: Medicare does not pay for conditions due to TMJ. And Medicare coordinates with Medicaid on payable ...
Can I get Medicaid?	1/30/2008
Q: I am a 22 year old female from Columbus Ohio. I was diagnosed with PCS about 5 years ago. I haven't ... A: I apologize for not answering this sooner. I just did not see this til just now. In order to qualify ...
Medicaid share of cost program	1/28/2008
Q: My wife and I recently moved to Florida and we receive Medicaid through the "share of cost" program. ... A: I can only answer this for you about my limited knowledge of share of cost. This means that you have ...
medicare & PPO	1/24/2008
Q: I have medicare & a HMO. I am diabetic. I used insulin pump. I do not want to be with a HMO anymore. ... A: If you are in a Medicare HMO you can only leave during the open enrollment period (except for ...
florida medicaid	1/20/2008
Q: I'm in need of neck surgery but medicaid wont pay for surgery, is there any surgeons in FL that take ... A: I would not stop here. I would check with social service agencies, hospitals, different charities. ...
florida medicaid	1/20/2008
Q: I'm in need of neck surgery but medicaid wont pay for surgery, is there any surgeons in FL that take ... A: OK, now I understand. Call Medicaid and talk to someone there. (social worker) They have a list of ...
florida medicaid	1/20/2008
Q: I'm in need of neck surgery but medicaid wont pay for surgery, is there any surgeons in FL that take ... A: I am confused by your question. Are you saying that Medicaid will NOT pay for your surgery and if ...
Medicaid	1/20/2008
Q: I have Medicaid/Medicare. I afford pay as you go. I live in New Jersey and I need alot of work done ... A: Medicare will not pay for dental work. I would suggest that you call your local dental society and ...
Medicare/Private insurance billing	1/16/2008
Q: I'm about a week away from receiving my Medicare supplier number. My company deals only with durable ... A: Yes, you must be registered with each company. I assume that you already have your NPI number. Call ...
Blue cross Blue shiel card	1/14/2008
Q: Does BCBS card covers also the discounts on medicines when outside the country? My retired us ... A: You need to call your BCBS carrier (on the back of the card) and ask them the same questions that ...
Preexisting conditions and Medicare/Medicaid	1/6/2008
Q: My father had to have his colon removed last spring and was then insured by his employer. He has ... A: Neither Medicare nor Medicaid exclude pre-existing conditions. I think your father may have been ...
Medicare primary Aetna HMO 2ndry	1/4/2008
Q: ..I have a patient who has Medicare and Aetna HMO. There is no coordination of benefits. We bill ... A: Hmm..There are different types of Aetna HMO's. I would definitely get the patient's id card from ...
Medicaid	1/2/2008
Q: i live in mecklenburg county in north carolina. I turn twenty this month. i dont have any kind of ... A: Heather..I apologize for not answering this earlier. I was having problems logging on. You need to ...
insurance	12/31/2007
Q: I own a small business (Dominos Pizza) in a very small market.We not only cover our family but we ... A: There is no way to find out what the drug cost. And it would make no difference in the cost. ...
prostate biopsy	12/21/2007
Q: Does Medicare cover a prostate biopsy? If so, what percentage does it cover? A: Yes, Medicare covers a prostate biopsy if it is medically indicated. If your physician is ...
How does a provider submit claim	12/15/2007
Q: I am the only Medicare patient of a psychologist who has agreed to become a Medicare provider. I ... A: .You cannot submit the claim. Your doctor must do it. The form is a CMS-1500 form and you cannot ...
Psychologist joining Medicare	12/12/2007
Q: I went on Medicare a year ago. I go to a psychologist who is not a Medicare provider. I am his only ... A: You should not be the one taking care of this process. There is personal information on the forms. ...
young single adult medical coverage	11/27/2007
Q: I have a 23-year-old daughter that needs basic health insurance for pre-existing conditions. My ... A: The only govt plan that I know of..(federal) is Medicaid and she would have to see if she qualifies ...
Autistic Child	11/19/2007
Q: my boyfriend pays child support and was mandated to provide health insurance for the child. The ... A: I am still confused as to why this child's primary insurance is not Aetna. It could because she is a ...
Autistic Child	11/19/2007
Q: my boyfriend pays child support and was mandated to provide health insurance for the child. The ... A: I need clarification about something. I assume that you are talking about a Medicaid HMO and not an ...
Follow up	11/17/2007
Q: Merry-- Your answer was tremendously helpful and suggests a couple of other questions. As I ... A: .There is no such thing as permanent supplemental insurance so I am not sure what that means. ...
Two Medicare questions	11/16/2007
Q: I have a friend who has just gone on Medicare. She had cancer six years ago. She is now ... A: Steve..not an easy question to answer. Did she have insurance up to the day that she went on ...
inpatient and outpatient hospital bills	11/9/2007
Q: My mother is a Medicare Beneficiary who has had a recent outpatient procedure done in a hospital. ... A: There is no average. Hospitals bill electronically so they should receive their payment within 30 ...
Individual health insurance	11/6/2007
Q: In Colorado, can I be denied indivdual coverage by an insurance company if I have been continually ... A: As you probably know, the HIPAA laws differ greatly with group and individual coverage. I can only ...
wellcare	10/29/2007
Q: I have a policyholder who has Wellcare and is confused. I am trying to help her. Does Wellcare ... A: Wellcare is a large company. Your client may have Wellcare as a Medicare Advantage Plan (think HMO) ...
Medicare eligibility	10/28/2007
Q: My parents, 73 and 67, are permanent residents here since December 2005. They currently residing the ... A: Kumar..I would have them call Medicare at 800-772-1213 (during the week is better as the wait can be ...
Medicare Saving Program and extra help prescription help	10/25/2007
Q: I would like to know if 401K, and pension are considered resources when it comes to determine if an ... A: Yes, your 401K and pensions are considered resources for determination. This is for both programs. I ...
supplemental insurance	10/23/2007
Q: my husband will be 65,next year,will he need supplemental insurce when on medicare,even though he is ... A: An excellent question. You need to ask someone at your work that understands this (HR?) and see if ...
medicare	10/22/2007
Q: I am a Belite lap band patient and I have a lap band surgery coming up. Since Belite wont answer ... A: Angelia..It is not true that Medicare will pay for transportation. Medicare does not pay for this ...
weight loss surgery	10/20/2007
Q: Do you know if Medicare will pay for weight loss surgery and if so how can I prove all the weight ... A: Yes, Medicare would pay the bulk of the expense and if you have Medi-Cal, you would not be ...
weight loss surgery	10/20/2007
Q: Do you know if Medicare will pay for weight loss surgery and if so how can I prove all the weight ... A: .Medicare does pay for this surgery but there are certain guidelines that must be followed. And, not ...

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