RE: Medicare part b 10% additional preminum

[Guest guest]

Pts are charged an additional 10% premium penalty for each year that

they could have had Part B, but didn't get it (refused to). The only

exception is if they have another event later that qualifies them for

Medicare on a different basis. Then they can get Part B added without

the penalty.

Fred L. Forsthoffer, MBA

Financial Analyst

Banner Samaritan Transplant Services

, , F-

Medicare part b 10% additional

preminum

Hello fellow TFC's,

Does anyone know if ESRD patients who do not sign up for Medicare Part

B at the time of Part A enrollment will be charged the extra 10% if they

later sign up during general enrollment or are they in the " special

cases " category? I couldn't find the answer on the Medicare web site.

Thanks

Hartford Hospital Transplant Program

[Guest guest]

Patients can take Medicare Part A and elect not to take Part B if they have adequate coverage. This applies to patients that are planning on getting a transplant and have adequate insurance for drugs etc. They have a window of opportunity at the time of transplant to apply for Part B without the 10% penalty. I think they have 90 days to apply without the penalty.

I have many patients with government insurance who do not want Part B and have a $100 bill to pay when their other insurance coveres them.

CIGNA recently sent one of our patietns a letter indicating they would only pay 20% since their 30 month coordination of benefit period was up. This person had to go to Social Security and indicate a Life Event and they were able to get the Part B without penalty.

I do not have this in verbage from Social Security but for our renal patients it has worked out.

Part B is a deal for $100 but getting patients to see it is difficult. I had another gentleman who received a living related tx and the month before the transplant his boss terminated him and would not let him take COBRA. Because it was a small business and self-funded this ruling stood. He was able to get his B reinstated because of his living related tx without penalty. They need to take the 2728 form with them to Social SEcurity when they apply for Part B after transplant. Bev>>> jbucche@... 11/2/2004 1:40:35 PM >>>

Hello fellow TFC's,Does anyone know if ESRD patients who do not sign up for Medicare PartB at the time of Part A enrollment will be charged the extra 10% if theylater sign up during general enrollment or are they in the "specialcases" category? I couldn't find the answer on the Medicare web site.ThanksHartford Hospital Transplant Program

[Guest guest]

Maybe this is an old topic but...is everyone getting that same message from Cigna (see red highlight)? We hear this but inconsistently, and I'm wondering if this is an immutable policy of the payor which they sometimes neglect to say, or if it's up to the employer to stipulate it?

-----Original Message-----From: BEVERLY A. LARSON Sent: Tuesday, November 02, 2004 12:48 PMTo: TxFinancialCoordinators Subject: Re: Medicare part b 10% additional preminum

Patients can take Medicare Part A and elect not to take Part B if they have adequate coverage. This applies to patients that are planning on getting a transplant and have adequate insurance for drugs etc. They have a window of opportunity at the time of transplant to apply for Part B without the 10% penalty. I think they have 90 days to apply without the penalty.

I have many patients with government insurance who do not want Part B and have a $100 bill to pay when their other insurance coveres them.

CIGNA recently sent one of our patietns a letter indicating they would only pay 20% since their 30 month coordination of benefit period was up. This person had to go to Social Security and indicate a Life Event and they were able to get the Part B without penalty.

I do not have this in verbage from Social Security but for our renal patients it has worked out.

Part B is a deal for $100 but getting patients to see it is difficult. I had another gentleman who received a living related tx and the month before the transplant his boss terminated him and would not let him take COBRA. Because it was a small business and self-funded this ruling stood. He was able to get his B reinstated because of his living related tx without penalty. They need to take the 2728 form with them to Social SEcurity when they apply for Part B after transplant. Bev>>> jbucche@... 11/2/2004 1:40:35 PM >>>

Hello fellow TFC's,Does anyone know if ESRD patients who do not sign up for Medicare PartB at the time of Part A enrollment will be charged the extra 10% if theylater sign up during general enrollment or are they in the "specialcases" category? I couldn't find the answer on the Medicare web site.ThanksHartford Hospital Transplant Program

[Guest guest]

Something similar happened to us...once the insurance co found out the patient was eligible for Mcare & opted not to take it when he was eligible, they took their payment back for the transplant! There was a tiny clause in the Summary Plan Discription that the patient did not read. I believe it was the employer group that has the last word in these cases. Patient was able to get Mcare retro but very scary indeed. I always use this as my worse case scenario when patients don't want to apply for Mcare. -----Original Message-----From: on, :LPH Trnsplnt Sent: Wednesday, November 03, 2004 3:47 PMTo: TxFinancialCoordinators Subject: RE: Medicare part b 10% additional preminumMaybe this is an old topic but...is everyone getting that same message from Cigna (see red highlight)? We hear this but inconsistently, and I'm wondering if this is an immutable policy of the payor which they sometimes neglect to say, or if it's up to the employer to stipulate it?-----Original Message-----From: BEVERLY A. LARSON Sent: Tuesday, November 02, 2004 12:48 PMTo: TxFinancialCoordinators Subject: Re: Medicare part b 10% additional preminumPatients can take Medicare Part A and elect not to take Part B if they have adequate coverage. This applies to patients that are planning on getting a transplant and have adequate insurance for drugs etc. They have a window of opportunity at the time of transplant to apply for Part B without the 10% penalty. I think they have 90 days to apply without the penalty. I have many patients with government insurance who do not want Part B and have a $100 bill to pay when their other insurance coveres them. CIGNA recently sent one of our patietns a letter indicating they would only pay 20% since their 30 month coordination of benefit period was up. This person had to go to Social Security and indicate a Life Event and they were able to get the Part B without penalty. I do not have this in verbage from Social Security but for our renal patients it has worked out. Part B is a deal for $100 but getting patients to see it is difficult. I had another gentleman who received a living related tx and the month before the transplant his boss terminated him and would not let him take COBRA. Because it was a small business and self-funded this ruling stood. He was able to get his B reinstated because of his living related tx without penalty. They need to take the 2728 form with them to Social SEcurity when they apply for Part B after transplant. Bev>>> jbucche@... 11/2/2004 1:40:35 PM >>>Hello fellow TFC's,Does anyone know if ESRD patients who do not sign up for Medicare PartB at the time of Part A enrollment will be charged the extra 10% if theylater sign up during general enrollment or are they in the "specialcases" category? I couldn't find the answer on the Medicare web site.ThanksHartford Hospital Transplant Program