RE: Medicare 2 part question

[Guest guest]

At that point, they should probably try crying on the phone.

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.

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

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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]

Yes, they can. You can apply for Medicare based on the loss of coverage from your Commercial r. It is a real pain to do but it can be accomplished. Bev>>> "Battin, Daryl J." 11/9/2007 3:31 PM >>>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, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney/Pancreas Program41 Mall RoadBurlington, MA 01805PH: 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,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 OsborneSee 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]

Obviously this would not be an issue if they did not have active Medicare. The Commercial r could not expect a Medicare EOB if pt was not eligible.>>> "Battin, Daryl J." 11/9/2007 3:48 PM >>>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, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney/Pancreas Program41 Mall RoadBurlington, MA 01805PH: 781 744-7166/FAX: 781 744-5009 -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Glor, L.Sent: Friday, November 09, 2007 3:34 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, LICSWFinancial Coordinator/Social WorkerLahey Clinic Kidney/Pancreas Program41 Mall RoadBurlington, MA 01805PH: 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,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 OsborneSee 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]

The patient can sign up for Medicare because he or she is still eligible.

In your example, he or she will lose out on retro coverage for the

transplant - and therefore will get no help from Part B on immunos - since

more than 12 months has passed since the transplant, but they will still be

entitled as of the month they file the claim

>>> " Battin, Daryl J. " 11/9/2007 3:31 PM >>>

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.

IMPORTANT NOTICE: This communication, including any attachment, contains

information that may be confidential or privileged, and is intended solely

for the entity or individual to whom it is addressed. If you are not the

intended recipient, you should contact the sender and delete the message.

Any unauthorized disclosure, copying, or distribution of this message is

strictly prohibited. Nothing in this email, including any attachment, is

intended to be a legally binding signature.

[Guest guest]

The patient can sign up for Medicare because he or she is still eligible.

In your example, he or she will lose out on retro coverage for the

transplant - and therefore will get no help from Part B on immunos - since

more than 12 months has passed since the transplant, but they will still be

entitled as of the month they file the claim

>>> " Battin, Daryl J. " 11/9/2007 3:31 PM >>>

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.

IMPORTANT NOTICE: This communication, including any attachment, contains

information that may be confidential or privileged, and is intended solely

for the entity or individual to whom it is addressed. If you are not the

intended recipient, you should contact the sender and delete the message.

Any unauthorized disclosure, copying, or distribution of this message is

strictly prohibited. Nothing in this email, including any attachment, is

intended to be a legally binding signature.

[Guest guest]

Despite the rising cost of the Part B premium, we are still urging all of our pts to put Parts A and B in place at the time of transplant if they aren't yet enrolled. We are living in very uncertain times as far as EGHPs are concerned and Medicare is the only guarantee our patients have for at least the 3 yr post op period. Sales of "consumer-driven" high-deductible plans (I prefer Dukasis' name for them: "Screw the little guy plans") are on the rise and I've never seen one yet with commensurate contributions to an HSA by the employer to mitigate for the outrageous OOP expenses.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Do what you feel in your heart to be right - for you'll be criticized anyway. You'll be damned if you do, and damned if you don't." Eleanor Roosevelt

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Lovely, Janet M.Sent: Thursday, November 08, 2007 2:54 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

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

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

[Guest guest]

Despite the rising cost of the Part B premium, we are still urging all of our pts to put Parts A and B in place at the time of transplant if they aren't yet enrolled. We are living in very uncertain times as far as EGHPs are concerned and Medicare is the only guarantee our patients have for at least the 3 yr post op period. Sales of "consumer-driven" high-deductible plans (I prefer Dukasis' name for them: "Screw the little guy plans") are on the rise and I've never seen one yet with commensurate contributions to an HSA by the employer to mitigate for the outrageous OOP expenses.

on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@...

"Do what you feel in your heart to be right - for you'll be criticized anyway. You'll be damned if you do, and damned if you don't." Eleanor Roosevelt

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Lovely, Janet M.Sent: Thursday, November 08, 2007 2:54 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part question

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

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

[Guest guest]

You are so right. Bev Larson>>> "on, :LPH Trnsplnt" 11/9/2007 6:18 PM >>>Despite the rising cost of the Part B premium, we are still urging all of our pts to put Parts A and B in place at the time of transplant if they aren't yet enrolled. We are living in very uncertain times as far as EGHPs are concerned and Medicare is the only guarantee our patients have for at least the 3 yr post op period. Sales of "consumer-driven" high-deductible plans (I prefer Dukasis' name for them: "Screw the little guy plans") are on the rise and I've never seen one yet with commensurate contributions to an HSA by the employer to mitigate for the outrageous OOP expenses. on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org "Do what you feel in your heart to be right - for you'll be criticized anyway. You'll be damned if you do, and damned if you don't." Eleanor Roosevelt -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Lovely, Janet M.Sent: Thursday, November 08, 2007 2:54 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionI 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 OsborneIMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

[Guest guest]

You are so right. Bev Larson>>> "on, :LPH Trnsplnt" 11/9/2007 6:18 PM >>>Despite the rising cost of the Part B premium, we are still urging all of our pts to put Parts A and B in place at the time of transplant if they aren't yet enrolled. We are living in very uncertain times as far as EGHPs are concerned and Medicare is the only guarantee our patients have for at least the 3 yr post op period. Sales of "consumer-driven" high-deductible plans (I prefer Dukasis' name for them: "Screw the little guy plans") are on the rise and I've never seen one yet with commensurate contributions to an HSA by the employer to mitigate for the outrageous OOP expenses. on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorrisolhs (DOT) org "Do what you feel in your heart to be right - for you'll be criticized anyway. You'll be damned if you do, and damned if you don't." Eleanor Roosevelt -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Lovely, Janet M.Sent: Thursday, November 08, 2007 2:54 PMTo: TxFinancialCoordinators Subject: RE: Medicare 2 part questionI 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 OsborneIMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

[Guest guest]

Thanks -- I was just not sure if any commercial carrier could look back

and say the patient " should " have applied for Medicare at the time of

transplant and even if the COB period would have ended more than a year

after the transplant there would be potential issues with complete

commercial coverage. But since no longer eligible to sign up for

Medicare then looks like COB no longer a factor.

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]

Thanks -- I was just not sure if any commercial carrier could look back

and say the patient " should " have applied for Medicare at the time of

transplant and even if the COB period would have ended more than a year

after the transplant there would be potential issues with complete

commercial coverage. But since no longer eligible to sign up for

Medicare then looks like COB no longer a factor.

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 too urge all patients that are medicare eligible, (which is all with ERSD and

on dilysis) to enroll in Medicare A and B. This is sometime dificult with they

think all they need is commercial insurance.

My question is do you also urge them to enrol in D when they drug coverage thru

their commercial insurance?

Amellia Gay, TFC

East Texas Medical Center

Tyler, TX

>>> " on, :LPH Trnsplnt " 11/9/2007 5:18 PM >>>

Despite the rising cost of the Part B premium, we are still urging all of

our pts to put Parts A and B in place at the time of transplant if they

aren't yet enrolled. We are living in very uncertain times as far as EGHPs

are concerned and Medicare is the only guarantee our patients have for at

least the 3 yr post op period. Sales of " consumer-driven " high-deductible

plans (I prefer Dukasis' name for them: " Screw the little guy

plans " ) are on the rise and I've never seen one yet with commensurate

contributions to an HSA by the employer to mitigate for the outrageous OOP

expenses.

on

Financial Counselor

Legacy Transplant Services

1040 NW 22nd Ave Ste 480

Portland OR 97210

toll free

fax

lmorriso@...

" Do what you feel in your heart to be right - for you'll be criticized

anyway. You'll be damned if you do, and damned if you don't. " Eleanor

Roosevelt

[TxFinancialCoordin-ators] 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

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[Guest guest]

If Medicare is primary AND the commercial Rx plan will COB w/the D plan AND that results in cost savings for the patient, I will recommend it. Also will recommend if the commercial Rx plan is not considered creditable coverage. Otherwise no. Unlike medical coverage, I have yet to see a commercial RX plan refuse to pay primary for drugs at the end of the COB period if the pt does not have a D plan in place. If any other TFCs have run across that, it would be good to know.

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[TxFinancialCoordin-ators] 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 OsborneIMPORTANT NOTICE: This communication, including any attachment, containsinformation that may be confidential or privileged, and is intended solelyfor the entity or individual to whom it is addressed. If you are not theintended recipient, you should contact the sender and delete the message.Any unauthorized disclosure, copying, or distribution of this message isstrictly prohibited. Nothing in this email, including any attachment, isintended to be a legally binding signature.===========================================================This message is confidential, intended onlyfor the named recipient(s) and may containinformation that is privileged or exempt fromdisclosure under applicable law. If you arenot the intended recipient(s), you are notifiedthat the dissemination, distribution or copyingof this message is strictly prohibited. If youreceived this message in error, or are not thenamed recipient(s), please notify the senderand delete this e-mail from your computer.ETMC has implemented secure messaging forcertain types of messages. For more informationabout our secure messaging system, go to: http://www.etmc.org/mail/Thank you.===========================================================

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