RE: Medicare 2 part question

[Guest guest]

He can choose not to

get Medicare A and B at this time but before his COB period is over he should

get both.

Personally I rather

not deal with Part c which is a Medicare advantage plan. They can be tricky so

I like to see my pts. stick to the original Medicare plans.

If he has drug

coverage with Aetna he can only have 1 PDP

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoi@...

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of kelbe72

Sent: Thursday, November 08, 2007

10:43 AM

To:

TxFinancialCoordinators

Subject:

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna

and no

secondary. The benefits at Aetna are great and

have no deductibles or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

He can choose not to

get Medicare A and B at this time but before his COB period is over he should

get both.

Personally I rather

not deal with Part c which is a Medicare advantage plan. They can be tricky so

I like to see my pts. stick to the original Medicare plans.

If he has drug

coverage with Aetna he can only have 1 PDP

Beverly Antoine, LPN

Transplant Financial Coordinator

LSU-UMC

Laffayette, LA

bantoi@...

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of kelbe72

Sent: Thursday, November 08, 2007

10:43 AM

To:

TxFinancialCoordinators

Subject:

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna

and no

secondary. The benefits at Aetna are great and

have no deductibles or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

Thanks for your help Beverly.

Kelbe

>

> He can choose not to get Medicare A and B at this time but before

his

> COB period is over he should get both.

>

> Personally I rather not deal with Part c which is a Medicare

advantage

> plan. They can be tricky so I like to see my pts. stick to the

original

> Medicare plans.

>

>

>

> If he has drug coverage with Aetna he can only have 1 PDP

>

> Beverly Antoine, LPN

>

> Transplant Financial Coordinator

>

> LSU-UMC

>

> Laffayette, LA

>

>

>

> bantoi@...

>

>

>

>

>

>

>

>

>

> ________________________________

>

> From: TxFinancialCoordinators

> [mailto:TxFinancialCoordinators ] On Behalf Of

kelbe72

> Sent: Thursday, November 08, 2007 10:43 AM

> To: TxFinancialCoordinators

> Subject: Medicare 2 part question

>

>

>

> Hi

> I have a patient who is pre-kidney transplant who has Aetna and no

> secondary. The benefits at Aetna are great and have no deductibles

or

> high copays. Would it be in this patient's benefit to apply for

> Medicare or should they wait. The only thing I noticed is that

their

> drug copays are high. Another question, should every Medicare

patient

> apply for part C?

> Thank you

> Kelbe Osborne

>

[Guest guest]

Thanks for your help Beverly.

Kelbe

>

> He can choose not to get Medicare A and B at this time but before

his

> COB period is over he should get both.

>

> Personally I rather not deal with Part c which is a Medicare

advantage

> plan. They can be tricky so I like to see my pts. stick to the

original

> Medicare plans.

>

>

>

> If he has drug coverage with Aetna he can only have 1 PDP

>

> Beverly Antoine, LPN

>

> Transplant Financial Coordinator

>

> LSU-UMC

>

> Laffayette, LA

>

>

>

> bantoi@...

>

>

>

>

>

>

>

>

>

> ________________________________

>

> From: TxFinancialCoordinators

> [mailto:TxFinancialCoordinators ] On Behalf Of

kelbe72

> Sent: Thursday, November 08, 2007 10:43 AM

> To: TxFinancialCoordinators

> Subject: Medicare 2 part question

>

>

>

> Hi

> I have a patient who is pre-kidney transplant who has Aetna and no

> secondary. The benefits at Aetna are great and have no deductibles

or

> high copays. Would it be in this patient's benefit to apply for

> Medicare or should they wait. The only thing I noticed is that

their

> drug copays are high. Another question, should every Medicare

patient

> apply for part C?

> Thank you

> Kelbe Osborne

>

[Guest guest]

I would advise a patient in this situation to get Medicare part A at the time of the txp. - to insure that they have Medicare coverage for immunos. when they turn 65. As far as getting B - it becomes a financial issue. If the copays for immunos. will be greater than the part B premium, it may make sense to get that coverage. Also, if there is a living donor, it's nice to have the part B coverage as back up. Hope this helps.

The patient needs to be informed that there may be a financial penalty if they pick up A and not B at that time and there are restrictions as to when they can obtain the additional coverage if they wait.

It doesn't sound like this patient needs Medicare D since he has prescription drug coverage, but again, the patient needs to do the math (and consider the donut hole where there is no coverage).

Janet M. Lovely

Lankenau Hospital

Phila., PA

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part question

HiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

[Guest guest]

I would advise a patient in this situation to get Medicare part A at the time of the txp. - to insure that they have Medicare coverage for immunos. when they turn 65. As far as getting B - it becomes a financial issue. If the copays for immunos. will be greater than the part B premium, it may make sense to get that coverage. Also, if there is a living donor, it's nice to have the part B coverage as back up. Hope this helps.

The patient needs to be informed that there may be a financial penalty if they pick up A and not B at that time and there are restrictions as to when they can obtain the additional coverage if they wait.

It doesn't sound like this patient needs Medicare D since he has prescription drug coverage, but again, the patient needs to do the math (and consider the donut hole where there is no coverage).

Janet M. Lovely

Lankenau Hospital

Phila., PA

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part question

HiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

[Guest guest]

I think more than for back-up if patient has a living donor with complications, Part B is the only coverage that will cover them. Bev L.>>> "Lovely, Janet M." 11/8/2007 5:54 PM >>>I would advise a patient in this situation to get Medicare part A at the time of the txp. - to insure that they have Medicare coverage for immunos. when they turn 65. As far as getting B - it becomes a financial issue. If the copays for immunos. will be greater than the part B premium, it may make sense to get that coverage. Also, if there is a living donor, it's nice to have the part B coverage as back up. Hope this helps. The patient needs to be informed that there may be a financial penalty if they pick up A and not B at that time and there are restrictions as to when they can obtain the additional coverage if they wait. It doesn't sound like this patient needs Medicare D since he has prescription drug coverage, but again, the patient needs to do the math (and consider the donut hole where there is no coverage). Janet M. LovelyLankenau HospitalPhila., PAFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part questionHiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

[Guest guest]

This is very helpful information, thanks for your help.

Kelbe

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

HI,

Please review the patient’s insurance

policy very, very carefully to make sure that there is no fine print that

indicates that when the patient is eligible for payment from Medicare that the

insurance will pay for services as if the patient was having Medicare pay for

the balance. (Does this make sense?) We don’t want the patient

to be surprised if the policy will pay differently if the patient “should

have” Medicare.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Osborne, Kelbe

Sent: Friday, November 09, 2007

8:11 AM

To:

TxFinancialCoordinators

Subject: RE:

Medicare 2 part question

This is very helpful information, thanks for your

help.

Kelbe

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna

and no

secondary. The benefits at Aetna are great and

have no deductibles or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

Hi Bill

I will definitely

review the patient’s insurance info to see it adopting Medicare will be a

problem for the patient. Thank you for your assistance.

Kelbe

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Vaughan

Sent: Friday, November 09, 2007

8:46 AM

To:

TxFinancialCoordinators

Subject: RE:

Medicare 2 part question

HI,

Please review the patient’s insurance

policy very, very carefully to make sure that there is no fine print that indicates

that when the patient is eligible for payment from Medicare that the insurance

will pay for services as if the patient was having Medicare pay for the

balance. (Does this make sense?) We don’t want the patient to

be surprised if the policy will pay differently if the patient “should

have” Medicare.

Hope this helps,

Thanks,

Bill

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Osborne, Kelbe

Sent: Friday, November 09, 2007

8:11 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare 2 part question

This is

very helpful information, thanks for your help.

Kelbe

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

Hi Bill

I will definitely

review the patient’s insurance info to see it adopting Medicare will be a

problem for the patient. Thank you for your assistance.

Kelbe

From:

TxFinancialCoordinators

[mailto:TxFinancialCoordinators ] On Behalf Of Vaughan

Sent: Friday, November 09, 2007

8:46 AM

To:

TxFinancialCoordinators

Subject: RE:

Medicare 2 part question

HI,

Please review the patient’s insurance

policy very, very carefully to make sure that there is no fine print that indicates

that when the patient is eligible for payment from Medicare that the insurance

will pay for services as if the patient was having Medicare pay for the

balance. (Does this make sense?) We don’t want the patient to

be surprised if the policy will pay differently if the patient “should

have” Medicare.

Hope this helps,

Thanks,

Bill

From:

TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of Osborne, Kelbe

Sent: Friday, November 09, 2007

8:11 AM

To: TxFinancialCoordinators

Subject: RE:

Medicare 2 part question

This is

very helpful information, thanks for your help.

Kelbe

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

This is true of CIGNA. After 30 month coordination of benefit period they will not pay without Medicare EOB. Bev>>> " Vaughan" 11/9/2007 8:46 AM >>>HI,Please review the patient’s insurance policy very, very carefully to make sure that there is no fine print that indicates that when the patient is eligible for payment from Medicare that the insurance will pay for services as if the patient was having Medicare pay for the balance. (Does this make sense?) We don’t want the patient to be surprised if the policy will pay differently if the patient “should have†Medicare. Hope this helps,Thanks,BillFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Osborne, KelbeSent: Friday, November 09, 2007 8:11 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionThis is very helpful information, thanks for your help.Kelbe-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY ALARSONSent: Friday, November 09, 2007 8:05 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionI think more than for back-up if patient has a living donor withcomplications, Part B is the only coverage that will cover them. Bev L.>>> "Lovely, Janet M." <lovelyjmlhs (DOT) org> 11/8/2007 5:54 PM >>>I would advise a patient in this situation to get Medicare part A at thetime of the txp. - to insure that they have Medicare coverage forimmunos. when they turn 65. As far as getting B - it becomes afinancial issue. If the copays for immunos. will be greater than thepart B premium, it may make sense to get that coverage. Also, if thereis a living donor, it's nice to have the part B coverage as back up.Hope this helps. The patient needs to be informed that there may be a financial penaltyif they pick up A and not B at that time and there are restrictions asto when they can obtain the additional coverage if they wait.It doesn't sound like this patient needs Medicare D since he hasprescription drug coverage, but again, the patient needs to do the math(and consider the donut hole where there is no coverage).Janet M. LovelyLankenau HospitalPhila., PAFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part questionHiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

[Guest guest]

This is true of CIGNA. After 30 month coordination of benefit period they will not pay without Medicare EOB. Bev>>> " Vaughan" 11/9/2007 8:46 AM >>>HI,Please review the patient’s insurance policy very, very carefully to make sure that there is no fine print that indicates that when the patient is eligible for payment from Medicare that the insurance will pay for services as if the patient was having Medicare pay for the balance. (Does this make sense?) We don’t want the patient to be surprised if the policy will pay differently if the patient “should have†Medicare. Hope this helps,Thanks,BillFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Osborne, KelbeSent: Friday, November 09, 2007 8:11 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionThis is very helpful information, thanks for your help.Kelbe-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY ALARSONSent: Friday, November 09, 2007 8:05 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionI think more than for back-up if patient has a living donor withcomplications, Part B is the only coverage that will cover them. Bev L.>>> "Lovely, Janet M." <lovelyjmlhs (DOT) org> 11/8/2007 5:54 PM >>>I would advise a patient in this situation to get Medicare part A at thetime of the txp. - to insure that they have Medicare coverage forimmunos. when they turn 65. As far as getting B - it becomes afinancial issue. If the copays for immunos. will be greater than thepart B premium, it may make sense to get that coverage. Also, if thereis a living donor, it's nice to have the part B coverage as back up.Hope this helps. The patient needs to be informed that there may be a financial penaltyif they pick up A and not B at that time and there are restrictions asto when they can obtain the additional coverage if they wait.It doesn't sound like this patient needs Medicare D since he hasprescription drug coverage, but again, the patient needs to do the math(and consider the donut hole where there is no coverage).Janet M. LovelyLankenau HospitalPhila., PAFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part questionHiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

[Guest guest]

So coverage for the immunos falls under part B right?

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

yes. if they had Medicare at the time of tx. Bev>>> "Osborne, Kelbe" 11/9/2007 9:15 AM >>>So coverage for the immunos falls under part B right?-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY ALARSONSent: Friday, November 09, 2007 9:13 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionThis is true of CIGNA. After 30 month coordination of benefit periodthey will not pay without Medicare EOB. Bev>>> " Vaughan" <VaughanHSC-CLC (DOT) Com> 11/9/2007 8:46 AM >>>HI,Please review the patient's insurance policy very, very carefully tomake sure that there is no fine print that indicates that when thepatient is eligible for payment from Medicare that the insurance willpay for services as if the patient was having Medicare pay for thebalance. (Does this make sense?) We don't want the patient to besurprised if the policy will pay differently if the patient "shouldhave" Medicare. Hope this helps,Thanks,BillFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Osborne,KelbeSent: Friday, November 09, 2007 8:11 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionThis is very helpful information, thanks for your help.Kelbe-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY ALARSONSent: Friday, November 09, 2007 8:05 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionI think more than for back-up if patient has a living donor withcomplications, Part B is the only coverage that will cover them. Bev L.>>> "Lovely, Janet M." <lovelyjmlhs (DOT) org> 11/8/2007 5:54 PM >>>I would advise a patient in this situation to get Medicare part A at thetime of the txp. - to insure that they have Medicare coverage forimmunos. when they turn 65. As far as getting B - it becomes afinancial issue. If the copays for immunos. will be greater than thepart B premium, it may make sense to get that coverage. Also, if thereis a living donor, it's nice to have the part B coverage as back up.Hope this helps. The patient needs to be informed that there may be a financial penaltyif they pick up A and not B at that time and there are restrictions asto when they can obtain the additional coverage if they wait.It doesn't sound like this patient needs Medicare D since he hasprescription drug coverage, but again, the patient needs to do the math(and consider the donut hole where there is no coverage).Janet M. LovelyLankenau HospitalPhila., PAFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part questionHiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

[Guest guest]

Thanks Beverly.

Kelbe

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

Thanks Beverly.

Kelbe

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

[Guest guest]

If after all of our

explaining etc. a post-transplant patient still does not sign up for Medicare –

can a commercial insurance company 30 months after transplant (given no

dialysis for example) act if there still is a COB period and only pay 20% even

though the patient can no longer sign up for Medicare at that point (as more

than a year past transplant)? Hope what I have just said makes sense.

Thanks for your insight!

Daryl Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney/Pancreas Program

41 Mall Road

Burlington, MA 01805

PH: 781 744-7166/FAX: 781

744-5009

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

If after all of our

explaining etc. a post-transplant patient still does not sign up for Medicare –

can a commercial insurance company 30 months after transplant (given no

dialysis for example) act if there still is a COB period and only pay 20% even

though the patient can no longer sign up for Medicare at that point (as more

than a year past transplant)? Hope what I have just said makes sense.

Thanks for your insight!

Daryl Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney/Pancreas Program

41 Mall Road

Burlington, MA 01805

PH: 781 744-7166/FAX: 781

744-5009

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

If after all of our

explaining etc. a post-transplant patient still does not sign up for Medicare –

can a commercial insurance company 30 months after transplant (given no

dialysis for example) act if there still is a COB period and only pay 20% even

though the patient can no longer sign up for Medicare at that point (as more

than a year past transplant)? Hope what I have just said makes sense.

Thanks for your insight!

Daryl Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney/Pancreas Program

41 Mall Road

Burlington, MA 01805

PH: 781 744-7166/FAX: 781

744-5009

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

We’ve seen that

happen multiple times with pts who did not sign up for MC and were out of COB

period. Even though MC cov was not in place, Group Health coverage stated

their primary did not pay so they would not pay. Then pt was being billed full

cost for services. Patient’s tend to go for the retroactive eff date

with Medicare once that happens.

Glor

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

See our web page at

http://www.lahey.org for a full directory of Lahey sites, staff, services

and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO

WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not

the intended recipient, your use of this message for any purpose is strictly

prohibited. If you have received this communication in error, please delete the

message and notify the sender so that we may correct our records.

[Guest guest]

We’ve seen that

happen multiple times with pts who did not sign up for MC and were out of COB

period. Even though MC cov was not in place, Group Health coverage stated

their primary did not pay so they would not pay. Then pt was being billed full

cost for services. Patient’s tend to go for the retroactive eff date

with Medicare once that happens.

Glor

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

See our web page at

http://www.lahey.org for a full directory of Lahey sites, staff, services

and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO

WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED,

CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not

the intended recipient, your use of this message for any purpose is strictly

prohibited. If you have received this communication in error, please delete the

message and notify the sender so that we may correct our records.

[Guest guest]

How can they get a retro date if try to apply more than a year after transplant?

If not on disability for 24 months or over 65 would no longer be Medicare

eligible ???

Daryl Battin, LICSW

Financial

Coordinator/Social Worker

Lahey Clinic

Kidney/Pancreas Program

41 Mall Road

Burlington, MA 01805

PH: 781 744-7166/FAX: 781

744-5009

Medicare 2 part question

Hi

I have a patient who is pre-kidney transplant who has Aetna and no

secondary. The benefits at Aetna are great and have no deductibles

or

high copays. Would it be in this patient's benefit to apply for

Medicare or should they wait. The only thing I noticed is that their

drug copays are high. Another question, should every Medicare patient

apply for part C?

Thank you

Kelbe Osborne

See

our web page at http://www.lahey.org for a full directory of Lahey sites,

staff, services and career opportunities.

THIS

MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY

CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE

UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this

message for any purpose is strictly prohibited. If you have received this

communication in error, please delete the message and notify the sender so that

we may correct our records.

[Guest guest]

F.Y.I.

A couple of times now, I've also run into 1 company that not only will they not pay, they sent their member a letter stating that if they did not enroll in Medicare Part A & B by the end of their 30-month ESRD Medicare coordination period...that they were dropping their coverage with that company. That's one way to get a patient to hustle to get coverage in place.

Tyler

Sacred Heart Med Ctr.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Glor, L.Sent: Friday, November 09, 2007 12:34 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

We’ve seen that happen multiple times with pts who did not sign up for MC and were out of COB period. Even though MC cov was not in place, Group Health coverage stated their primary did not pay so they would not pay. Then pt was being billed full cost for services. Patient’s tend to go for the retroactive eff date with Medicare once that happens.

Glor

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Friday, November 09, 2007 3:32 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

If after all of our explaining etc. a post-transplant patient still does not sign up for Medicare – can a commercial insurance company 30 months after transplant (given no dialysis for example) act if there still is a COB period and only pay 20% even though the patient can no longer sign up for Medicare at that point (as more than a year past transplant)? Hope what I have just said makes sense. Thanks for your insight!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney/Pancreas Program

41 Mall Road

Burlington, MA 01805

PH: 781 744-7166/FAX: 781 744-5009

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of VaughanSent: Friday, November 09, 2007 8:46 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

HI,

Please review the patient’s insurance policy very, very carefully to make sure that there is no fine print that indicates that when the patient is eligible for payment from Medicare that the insurance will pay for services as if the patient was having Medicare pay for the balance. (Does this make sense?) We don’t want the patient to be surprised if the policy will pay differently if the patient “should have” Medicare.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Osborne, KelbeSent: Friday, November 09, 2007 8:11 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

This is very helpful information, thanks for your help.Kelbe-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY ALARSONSent: Friday, November 09, 2007 8:05 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionI think more than for back-up if patient has a living donor withcomplications, Part B is the only coverage that will cover them. Bev L.>>> "Lovely, Janet M." <lovelyjmlhs (DOT) org> 11/8/2007 5:54 PM >>>I would advise a patient in this situation to get Medicare part A at thetime of the txp. - to insure that they have Medicare coverage forimmunos. when they turn 65. As far as getting B - it becomes afinancial issue. If the copays for immunos. will be greater than thepart B premium, it may make sense to get that coverage. Also, if thereis a living donor, it's nice to have the part B coverage as back up.Hope this helps. The patient needs to be informed that there may be a financial penaltyif they pick up A and not B at that time and there are restrictions asto when they can obtain the additional coverage if they wait.It doesn't sound like this patient needs Medicare D since he hasprescription drug coverage, but again, the patient needs to do the math(and consider the donut hole where there is no coverage).Janet M. LovelyLankenau HospitalPhila., PAFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part questionHiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

F.Y.I.

A couple of times now, I've also run into 1 company that not only will they not pay, they sent their member a letter stating that if they did not enroll in Medicare Part A & B by the end of their 30-month ESRD Medicare coordination period...that they were dropping their coverage with that company. That's one way to get a patient to hustle to get coverage in place.

Tyler

Sacred Heart Med Ctr.

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Glor, L.Sent: Friday, November 09, 2007 12:34 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

We’ve seen that happen multiple times with pts who did not sign up for MC and were out of COB period. Even though MC cov was not in place, Group Health coverage stated their primary did not pay so they would not pay. Then pt was being billed full cost for services. Patient’s tend to go for the retroactive eff date with Medicare once that happens.

Glor

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Battin, Daryl J.Sent: Friday, November 09, 2007 3:32 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

If after all of our explaining etc. a post-transplant patient still does not sign up for Medicare – can a commercial insurance company 30 months after transplant (given no dialysis for example) act if there still is a COB period and only pay 20% even though the patient can no longer sign up for Medicare at that point (as more than a year past transplant)? Hope what I have just said makes sense. Thanks for your insight!

Daryl Battin, LICSW

Financial Coordinator/Social Worker

Lahey Clinic Kidney/Pancreas Program

41 Mall Road

Burlington, MA 01805

PH: 781 744-7166/FAX: 781 744-5009

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of VaughanSent: Friday, November 09, 2007 8:46 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

HI,

Please review the patient’s insurance policy very, very carefully to make sure that there is no fine print that indicates that when the patient is eligible for payment from Medicare that the insurance will pay for services as if the patient was having Medicare pay for the balance. (Does this make sense?) We don’t want the patient to be surprised if the policy will pay differently if the patient “should have” Medicare.

Hope this helps,

Thanks,

Bill

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Osborne, KelbeSent: Friday, November 09, 2007 8:11 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

This is very helpful information, thanks for your help.Kelbe-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of BEVERLY ALARSONSent: Friday, November 09, 2007 8:05 AMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionI think more than for back-up if patient has a living donor withcomplications, Part B is the only coverage that will cover them. Bev L.>>> "Lovely, Janet M." <lovelyjmlhs (DOT) org> 11/8/2007 5:54 PM >>>I would advise a patient in this situation to get Medicare part A at thetime of the txp. - to insure that they have Medicare coverage forimmunos. when they turn 65. As far as getting B - it becomes afinancial issue. If the copays for immunos. will be greater than thepart B premium, it may make sense to get that coverage. Also, if thereis a living donor, it's nice to have the part B coverage as back up.Hope this helps. The patient needs to be informed that there may be a financial penaltyif they pick up A and not B at that time and there are restrictions asto when they can obtain the additional coverage if they wait.It doesn't sound like this patient needs Medicare D since he hasprescription drug coverage, but again, the patient needs to do the math(and consider the donut hole where there is no coverage).Janet M. LovelyLankenau HospitalPhila., PAFrom: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of kelbe72Sent: Thursday, November 08, 2007 11:43 AMTo: TxFinancialCoordinators Subject: Medicare 2 part questionHiI have a patient who is pre-kidney transplant who has Aetna and no secondary. The benefits at Aetna are great and have no deductibles or high copays. Would it be in this patient's benefit to apply for Medicare or should they wait. The only thing I noticed is that their drug copays are high. Another question, should every Medicare patient apply for part C?Thank youKelbe Osborne

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.

THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.