Guest guest Posted February 1, 2008 Report Share Posted February 1, 2008 hi Debbie, my thought is that is it's not Medicare's or the health plan's call as to whether the pt "needs" Medicare - if she's eligible and wants to sign up and you advise it, she should enroll. on Financial Counselor Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 toll free fax lmorriso@... "Ring out old shapes of foul disease, Ring out the narrowing lust of gold; Ring out the thousand wars of old, Ring in the thousand years of peace." - Alfred Lord Tennyson -----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Mast, DeborahSent: Friday, February 01, 2008 9:03 AMTo: TxFinancialCoordinators Subject: kidney pt/Medicare I have a patient who recently had a kidney transplant who was not previously on dialysis. I advised them to take Medicare at the time of transplant as their health plan coverage is an individual policy and Medicare would be the primary coverage based on ESRD. The patient is now calling me and telling me that both Medicare and the health plan are stating she does not need to apply for Medicare. I am trying to provide something in writing to them showing that Medicare is primary due to the individual policy. However, the only things I can find all point to EGHP’s and ESRD COB. Does anyone know of something specifically addressing the individual plans? Thanks Debbie Mast Supervisor, Senior Transplant Financial Coordinator Stanford Hospital and Clinics 750 Welch Road, Suite 104 Palo Alto, CA 94304 Trustee, TFCA Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs Phone: Fax: 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 1, 2008 Report Share Posted February 1, 2008 I know that Medicare does not recognize the individual plan for COB - therefore, no 30 month period. They both act as primary. I don't now why either one would recommend that she not enroll in Medicare though and I would think that's the patient's choice and not their place to advise her. Craycraft Transplant Financial Coordinator University of Kansas Medical Center Fax lcraycraft@... >>> " Mast, Deborah " 02/01/2008 11:02 AM >>> I have a patient who recently had a kidney transplant who was not previously on dialysis. I advised them to take Medicare at the time of transplant as their health plan coverage is an individual policy and Medicare would be the primary coverage based on ESRD. The patient is now calling me and telling me that both Medicare and the health plan are stating she does not need to apply for Medicare. I am trying to provide something in writing to them showing that Medicare is primary due to the individual policy. However, the only things I can find all point to EGHP's and ESRD COB. Does anyone know of something specifically addressing the individual plans? Thanks Debbie Mast Supervisor, Senior Transplant Financial Coordinator Stanford Hospital and Clinics 750 Welch Road, Suite 104 Palo Alto, CA 94304 Trustee, TFCA Heart, Lung, Heart/Lung, Liver, Kidney, Pancreas, Intestinal Transplant Programs Phone: Fax: Quote Link to comment Share on other sites More sharing options...
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