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Medicare/Secondary Insurance

This post is for people with Medicare and a secondary insurance that is NOT a Medigap policy. 
 
 Did you know that if you have medical services that are not covered by Medicare, but ARE covered by your secondary insurance, there is a certain way you must submit your bills to the insurance? Suppose your doctor is opted out of Medicare, so you have to pay him up front and he gives you a statement to submit yourself. You MUST complete a 1490S form, found on the Medicare website. Attach copies of the bills from your provider to this form. Write in big bold letters: FOR DENIAL ONLY across the top of the form. Mail it to Medicare so that they will create a Summary of Benefits for this service denying payment. Then you must take a copy of that summary from Medicare, a copy of the bill, and your secondary insurance claim form, and send it in to the secondary insurance.
 
If you do not first send it in to Medicare, your secondary insurance will either deny payment outright stating you must first bill Medicare, or they will pay against some arbitrary number they have dreamed up as the amount Medicare would have paid.
 
This whole process sounds complicated, but it is really about being organized and keeping copies of everything.

11 Comments to Medicare/Secondary Insurance:

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photo playing cards on Friday, October 05, 2012 3:05 AM
Thanks for discussing the medicare process with us and giving a clear idea about the steps to be taken.
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Sebamed on Saturday, December 15, 2012 6:51 AM
I really appreciate your great effort to discus about this great point medicare which is really very beneficial from health point of view.


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treating psoriasis on Monday, October 29, 2012 6:54 AM
If person is having more than one insurance plan, then one of those insurances pays primary, and the other pays secondary and this other insurance pays for whatever costs are left over, such as copayments.
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MaxoLash on Monday, November 12, 2012 1:23 AM
Wonderful article ,I really appreciated from it,I was searching this information in past, So I really thankful to you for providing me a nice information,Thanks again.
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Sunshine Summit Lodge on Thursday, November 15, 2012 12:42 AM
One of the biggest challenges facing the healthcare industry is the question of enhancing customer experience beyond the obvious. It is taken for granted that customers require high quality medical care beyond any other considerations. However, companies that wish to go ahead of the competition have to think what they can do in addition to this or else they will be left behind.
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biogetica on Friday, November 16, 2012 11:31 PM
Medigap insurance is voluntary and you are responsible for the monthly or quarterly premium. Medicare will not pay any of your costs to purchase a Medigap policy.
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isabel marant sneakers on Wednesday, November 28, 2012 2:36 AM
It's just what I was searching for. I am always interested in this subject. Thanks for sharing.
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online casino on Thursday, December 13, 2012 7:50 AM
A plan provided through retirement resulting from past employment. For Medicare to be secondary, the coverage must be the result of current employment status. The Medicare beneficiary may be retired and have retiree coverage. If the spouse is still employed and provides coverage, this coverage will be primary to Medicare.
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