Guest guest Posted November 16, 2004 Report Share Posted November 16, 2004 Assuming continuous HD from Dec, 2000, Medicare became primary to any EGHP Sept 1, 2003. Pt has ESRD Medicare until November 30, 2006 based upon the transplant date. He would lose his ESRD entitlement after Nov, 2006, then would revert to Disability Medicare coordination rules. Since he started working in May, 2004, you would expect him to lose his Disability Medicare when no longer documented as disabled. As long as he shows as covered, if he is actively working EGHP would be primary, and Medicare secondary. (Don’t know what Medicomp is.) Fred L. Forsthoffer, MBA Financial Analyst Banner Samaritan Transplant Services , , F- From: Hogan, Sent: Tuesday, November 16, 2004 10:31 AM To: TFC group (E-mail) Subject: COB PART 2 Hi Folks, Another scenario which nobody seems certain about. Started HD Dec, 2000. Stopped work, applied for SSDI and got Medicare March 2002 immediately when he applied for SSDI. Lost EGHP and went on medicomp Sept 2002. Kidney transplant December 2003. Back to work May 2004. Has EGHP August 2004 and the question is........who is primary? Thanks, Pat Hogan Transplant Financial Coordinator Lahey Clinic Burlington, MA Phone Fax 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2004 Report Share Posted November 16, 2004 I agree, he would have to go through the 30-month COB period. L. Woodward, BSM, TFC Renal Transplant Financial Coordinator University Hospital of Arkansas FAX From: Forsthoffer, Fred Sent: Tuesday, November 16, 2004 12:05 PMTo: TxFinancialCoordinators Subject: RE: COB PART 2 Assuming continuous HD from Dec, 2000, Medicare became primary to any EGHP Sept 1, 2003. Pt has ESRD Medicare until November 30, 2006 based upon the transplant date. He would lose his ESRD entitlement after Nov, 2006, then would revert to Disability Medicare coordination rules. Since he started working in May, 2004, you would expect him to lose his Disability Medicare when no longer documented as disabled. As long as he shows as covered, if he is actively working EGHP would be primary, and Medicare secondary. (Don’t know what Medicomp is.) Fred L. Forsthoffer, MBA Financial Analyst Banner Samaritan Transplant Services , , F- From: Hogan, Sent: Tuesday, November 16, 2004 10:31 AMTo: TFC group (E-mail)Subject: COB PART 2 Hi Folks, Another scenario which nobody seems certain about. Started HD Dec, 2000. Stopped work, applied for SSDI and got Medicare March 2002 immediately when he applied for SSDI. Lost EGHP and went on medicomp Sept 2002. Kidney transplant December 2003. Back to work May 2004. Has EGHP August 2004 and the question is........who is primary? Thanks, Pat Hogan Transplant Financial Coordinator Lahey Clinic Burlington, MA Phone Fax 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2004 Report Share Posted November 16, 2004 Medicomp is a Medicare supplement plan. Thanks for the explanation.... COB PART 2 Hi Folks, Another scenario which nobody seems certain about. Started HD Dec, 2000. Stopped work, applied for SSDI and got Medicare March 2002 immediately when he applied for SSDI. Lost EGHP and went on medicomp Sept 2002. Kidney transplant December 2003. Back to work May 2004. Has EGHP August 2004 and the question is........who is primary? Thanks, Pat Hogan Transplant Financial Coordinator Lahey Clinic Burlington, MA Phone Fax 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. 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2004 Report Share Posted November 16, 2004 Does he? As Fred said, he now is not entitled to disability Medicare since he went back to work, so the only entitlement is ESRD. Since he had his transplant in Dec 2003, he never really went through a COB period. I do think EGHP is primary but not sure why.... COB PART 2 Hi Folks, Another scenario which nobody seems certain about. Started HD Dec, 2000. Stopped work, applied for SSDI and got Medicare March 2002 immediately when he applied for SSDI. Lost EGHP and went on medicomp Sept 2002. Kidney transplant December 2003. Back to work May 2004. Has EGHP August 2004 and the question is........who is primary? Thanks, Pat Hogan Transplant Financial Coordinator Lahey Clinic Burlington, MA Phone Fax 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. 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. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 16, 2004 Report Share Posted November 16, 2004 Once a person becomes eligible for ESRD Medicare the 30-month coordination period begins. Whether or not they actually get Medicare. The 30-month period begins when they are eligible for ESRD Medicare, not when they become entitled to Medicare. Also, if I remember correctly, there is a time frame after a person is no longer eligible for Disability Medicare when they continue to have it. Someone else can verify this. I know it is a year if pts discontinue dialysis because they regain kidney function. Fred L. Forsthoffer, MBA Financial Analyst Banner Samaritan Transplant Services , , F- From: Hogan, Sent: Tuesday, November 16, 2004 12:45 PM To: TxFinancialCoordinators Subject: RE: COB PART 2 Does he? As Fred said, he now is not entitled to disability Medicare since he went back to work, so the only entitlement is ESRD. Since he had his transplant in Dec 2003, he never really went through a COB period. I do think EGHP is primary but not sure why.... COB PART 2 Hi Folks, Another scenario which nobody seems certain about. Started HD Dec, 2000. Stopped work, applied for SSDI and got Medicare March 2002 immediately when he applied for SSDI. Lost EGHP and went on medicomp Sept 2002. Kidney transplant December 2003. Back to work May 2004. Has EGHP August 2004 and the question is........who is primary? Thanks, Pat Hogan Transplant Financial Coordinator Lahey Clinic Burlington, MA Phone Fax 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. 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. Quote Link to comment Share on other sites More sharing options...
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