Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 Hello I am having a brain freeze.Scenerio:Patient has Medicare A since 03/01/95 due to disability and not ESRD.Patient receives his EGHP through his wife's employer and she is actively working. I am thinking that the EGHP is primary because he is not retired and disabled not by being on dialysis ? Thanks for any help Alesia Robles, Transplant Financial Coordinator Sutter Transplant and Outpatient Heart Specialty Clinics Fax Internet-mail Confidentiality: This E-Mail may contain material that is confidential, Privileged and/or attorney work product. If you are not he addressee indicated in this message (or responsible of the message to such person) you may not copy or deliver this message to anyone. In such case, you should destroy this message and kindly notify the sender by reply mail. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 EGHP would be primary if more than 100 employees in the group Robles, Alesia M. wrote: Hello I am having a brain freeze.Scenerio:Patient has Medicare A since 03/01/95 due to disability and not ESRD.Patient receives his EGHP through his wife's employer and she is actively working. I am thinking that the EGHP is primary because he is not retired and disabled not by being on dialysis ? Thanks for any help Alesia Robles, Transplant Financial Coordinator Sutter Transplant and Outpatient Heart Specialty Clinics Fax Internet-mail Confidentiality: This E-Mail may contain material that is confidential, Privileged and/or attorney work product. If you are not he addressee indicated in this message (or responsible of the message to such person) you may not copy or deliver this message to anyone. In such case, you should destroy this message and kindly notify the sender by reply mail. -------------------- This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 Sorry this should have been my entire answer: Medicare is the primary payer when beneficiaries have retiree coverage. In order for Medicare to be secondary payer, the individual must have coverage through his/her own or spouse’s current employment. *Working Aged*: Medicare is the secondary payer for beneficiaries who are age 65 or over and either: Work for an employer that has at least 20 employees, or * Have a spouse of any age who works for an employer with at least 20 employees. NOTE: Employer plans must offer aged Medicare beneficiaries and spouses the same health benefits under the same conditions offered to younger workers and spouses. *Disabled*: Medicare is the secondary payer when beneficiaries are under age 65 and: * Are entitled to Medicare based on disability, and * Are covered under a group health plan based on their own current employment status or the current employment status of a family member, and * The employer providing the group health coverage has 100 or more employees. Sioson wrote: > > EGHP would be primary if more than 100 employees in the group > > > > Robles, Alesia M. wrote: > >> Hello >> I am having a brain freeze.Scenerio:Patient has Medicare A since >> 03/01/95 due to disability and not ESRD.Patient receives his EGHP >> through his wife's employer and she is actively working. I am >> thinking that the EGHP is primary because he is not retired and >> disabled not by being on dialysis ? >> Thanks for any help >> *Alesia Robles, Transplant Financial Coordinator* >> *Sutter Transplant and Outpatient Heart Specialty Clinics* >> ** >> *Fax * >> Internet-mail Confidentiality: This E-Mail may contain >> material that is confidential, Privileged and/or attorney work >> product. If you are not he addressee indicated in this message (or >> responsible of the message to such person) you may not copy or >> deliver this message to anyone. In such case, you should destroy this >> message and kindly notify the sender by reply mail. >> > -------------------- > > This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. > > > -------------------- This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 Thanks so much! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Teressa LawrenceSent: Thursday, February 26, 2009 11:49 AMTo: TxFinancialCoordinators Subject: Re: COB Sorry this should have been my entire answer:Medicare is the primary payer when beneficiaries have retiree coverage. In order for Medicare to be secondary payer, the individual must have coverage through his/her own or spouse’s current employment.*Working Aged*: Medicare is the secondary payer for beneficiaries who are age 65 or over and either:Work for an employer that has at least 20 employees, or* Have a spouse of any age who works for an employer with at least20 employees.NOTE: Employer plans must offer aged Medicare beneficiaries and spouses the same health benefits under the same conditions offered to younger workers and spouses.*Disabled*: Medicare is the secondary payer when beneficiaries are under age 65 and:* Are entitled to Medicare based on disability, and* Are covered under a group health plan based on their own currentemployment status or the current employment status of a familymember, and* The employer providing the group health coverage has 100 or moreemployees. Sioson wrote:>> EGHP would be primary if more than 100 employees in the group>> >> Robles, Alesia M. wrote:>>> Hello>> I am having a brain freeze.Scenerio:Patient has Medicare A since >> 03/01/95 due to disability and not ESRD.Patient receives his EGHP >> through his wife's employer and she is actively working. I am >> thinking that the EGHP is primary because he is not retired and >> disabled not by being on dialysis ?>> Thanks for any help>> *Alesia Robles, Transplant Financial Coordinator*>> *Sutter Transplant and Outpatient Heart Specialty Clinics*>> **>> *Fax *>> Internet-mail Confidentiality: This E-Mail may contain>> material that is confidential, Privileged and/or attorney work >> product. If you are not he addressee indicated in this message (or >> responsible of the message to such person) you may not copy or >> deliver this message to anyone. In such case, you should destroy this >> message and kindly notify the sender by reply mail.>>> -------------------->> This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you.>> > --------------------This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 Thanks so much! From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Teressa LawrenceSent: Thursday, February 26, 2009 11:44 AMTo: TxFinancialCoordinators Subject: Re: COB **Medicare is the secondary payer when beneficiaries are under age 65 and:* Are entitled to Medicare based on disability, and* Are covered under a group health plan based on their own currentemployment status or the current employment status of a familymember, and* The employer providing the group health coverage has 100 or moreemployees.Hope this helps......Robles, Alesia M. wrote:>> > Hello> > I am having a brain freeze.Scenerio:Patient has Medicare A since > 03/01/95 due to disability and not ESRD.Patient receives his EGHP > through his wife's employer and she is actively working. I am thinking > that the EGHP is primary because he is not retired and disabled not by > being on dialysis ?> > Thanks for any help> > > *Alesia Robles, Transplant Financial Coordinator*> *Sutter Transplant and Outpatient Heart Specialty Clinics*> **> *Fax *> > > > > Internet-mail Confidentiality: This E-Mail may contain> material that is confidential, Privileged and/or attorney work > product. If you are not he addressee indicated in this message (or > responsible of the message to such person) you may not copy or deliver > this message to anyone. In such case, you should destroy this message > and kindly notify the sender by reply mail.> > > > >> --------------------This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 You're very welcome... Robles, Alesia M. wrote: > > Thanks so much! > > ------------------------------------------------------------------------ > *From:* TxFinancialCoordinators > [mailto:TxFinancialCoordinators ] *On Behalf Of > *Teressa Lawrence > *Sent:* Thursday, February 26, 2009 11:49 AM > *To:* TxFinancialCoordinators > *Subject:* Re: COB > > Sorry this should have been my entire answer: > > Medicare is the primary payer when beneficiaries have retiree coverage. > In order for Medicare to be secondary payer, the individual must have > coverage through his/her own or spouse’s current employment. > > *Working Aged*: Medicare is the secondary payer for beneficiaries who > are age 65 or over and either: > > Work for an employer that has at least 20 employees, or > > * Have a spouse of any age who works for an employer with at least > 20 employees. > > NOTE: Employer plans must offer aged Medicare beneficiaries and spouses > the same health benefits under the same conditions offered to younger > workers and spouses. > > *Disabled*: Medicare is the secondary payer when beneficiaries are under > age 65 and: > > * Are entitled to Medicare based on disability, and > * Are covered under a group health plan based on their own current > employment status or the current employment status of a family > member, and > * The employer providing the group health coverage has 100 or more > employees. > > Sioson wrote: > > > > EGHP would be primary if more than 100 employees in the group > > > > > > > > Robles, Alesia M. wrote: > > > >> Hello > >> I am having a brain freeze.Scenerio:Patient has Medicare A since > >> 03/01/95 due to disability and not ESRD.Patient receives his EGHP > >> through his wife's employer and she is actively working. I am > >> thinking that the EGHP is primary because he is not retired and > >> disabled not by being on dialysis ? > >> Thanks for any help > >> *Alesia Robles, Transplant Financial Coordinator* > >> *Sutter Transplant and Outpatient Heart Specialty Clinics* > >> ** > >> *Fax * > >> Internet-mail Confidentiality: This E-Mail may contain > >> material that is confidential, Privileged and/or attorney work > >> product. If you are not he addressee indicated in this message (or > >> responsible of the message to such person) you may not copy or > >> deliver this message to anyone. In such case, you should destroy this > >> message and kindly notify the sender by reply mail. > >> > > -------------------- > > > > This electronic message is intended to be for the use only of the > named recipient, and may contain information that is confidential or > privileged. If you are not the intended recipient, you are hereby > notified that any disclosure, copying, distribution or use of the > contents of this message is strictly prohibited. If you have received > this message in error or are not the named recipient, please notify us > immediately by contacting the sender at the electronic mail address > noted above, and delete and destroy all copies of this message. Thank you. > > > > > > > > -------------------- > > This electronic message is intended to be for the use only of the > named recipient, and may contain information that is confidential or > privileged. If you are not the intended recipient, you are hereby > notified that any disclosure, copying, distribution or use of the > contents of this message is strictly prohibited. If you have received > this message in error or are not the named recipient, please notify us > immediately by contacting the sender at the electronic mail address > noted above, and delete and destroy all copies of this message. Thank you. > > -------------------- This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2009 Report Share Posted February 26, 2009 Is it possible to obtain a copy of your financial assessment form that you use at your facility, please thanks? 504 988-7849 From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Teressa LawrenceSent: Thursday, February 26, 2009 2:04 PMTo: TxFinancialCoordinators Subject: Re: COB You're very welcome...Robles, Alesia M. wrote:>> Thanks so much!>> ----------------------------------------------------------> *From:* TxFinancialCoordinators > [mailto:TxFinancialCoordinators ] *On Behalf Of > *Teressa Lawrence> *Sent:* Thursday, February 26, 2009 11:49 AM> *To:* TxFinancialCoordinators > *Subject:* Re: COB>> Sorry this should have been my entire answer:>> Medicare is the primary payer when beneficiaries have retiree coverage.> In order for Medicare to be secondary payer, the individual must have> coverage through his/her own or spouse’s current employment.>> *Working Aged*: Medicare is the secondary payer for beneficiaries who> are age 65 or over and either:>> Work for an employer that has at least 20 employees, or>> * Have a spouse of any age who works for an employer with at least> 20 employees.>> NOTE: Employer plans must offer aged Medicare beneficiaries and spouses> the same health benefits under the same conditions offered to younger> workers and spouses.>> *Disabled*: Medicare is the secondary payer when beneficiaries are under> age 65 and:>> * Are entitled to Medicare based on disability, and> * Are covered under a group health plan based on their own current> employment status or the current employment status of a family> member, and> * The employer providing the group health coverage has 100 or more> employees.>> Sioson wrote:> >> > EGHP would be primary if more than 100 employees in the group> >> > > >> > Robles, Alesia M. wrote:> >> >> Hello> >> I am having a brain freeze.Scenerio:Patient has Medicare A since> >> 03/01/95 due to disability and not ESRD.Patient receives his EGHP> >> through his wife's employer and she is actively working. I am> >> thinking that the EGHP is primary because he is not retired and> >> disabled not by being on dialysis ?> >> Thanks for any help> >> *Alesia Robles, Transplant Financial Coordinator*> >> *Sutter Transplant and Outpatient Heart Specialty Clinics*> >> **> >> *Fax *> >> Internet-mail Confidentiality: This E-Mail may contain> >> material that is confidential, Privileged and/or attorney work> >> product. If you are not he addressee indicated in this message (or> >> responsible of the message to such person) you may not copy or> >> deliver this message to anyone. In such case, you should destroy this> >> message and kindly notify the sender by reply mail.> >>> > --------------------> >> > This electronic message is intended to be for the use only of the > named recipient, and may contain information that is confidential or > privileged. If you are not the intended recipient, you are hereby > notified that any disclosure, copying, distribution or use of the > contents of this message is strictly prohibited. If you have received > this message in error or are not the named recipient, please notify us > immediately by contacting the sender at the electronic mail address > noted above, and delete and destroy all copies of this message. Thank you.> >> >> >>> -------------------->> This electronic message is intended to be for the use only of the > named recipient, and may contain information that is confidential or > privileged. If you are not the intended recipient, you are hereby > notified that any disclosure, copying, distribution or use of the > contents of this message is strictly prohibited. If you have received > this message in error or are not the named recipient, please notify us > immediately by contacting the sender at the electronic mail address > noted above, and delete and destroy all copies of this message. Thank you.>> --------------------This electronic message is intended to be for the use only of the named recipient, and may contain information that is confidential or privileged. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution or use of the contents of this message is strictly prohibited. If you have received this message in error or are not the named recipient, please notify us immediately by contacting the sender at the electronic mail address noted above, and delete and destroy all copies of this message. Thank you. Quote Link to comment Share on other sites More sharing options...
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