Guest guest Posted May 13, 2003 Report Share Posted May 13, 2003 HI, I do not have my reference materials with me. Would someone that was at the conference please scan through them and double check on individual policies. I believe that when a person owns an individual policy that Medicare is primary, but please double check. I am sorry that I did not speak to this issue in New Orleans. Thanks, Bill P.S. Can some one tell me if I can send an attachment on this email " board " , if so, I will be happy to try to find what was in the book at UNOS to all. At 09:47 AM 5/13/2003, Craycraft wrote: >Same here, for individual policies only. I was also unable to be at the >conference; were individual policies included in that discussion at all? > >Thanks. > > Craycraft >Transplant Financial Coordinator >University of Kansas Medical Center > Fax >lcraycraft@... > > >>> dmbabbitt@... 05/12/03 05:04PM >>> >I was not at the conference, but our experience has been that if it is >an individual commercial policy Medicare will be primary at the time of >eligibility. The key is an individual policy/not a group policy. >Medicare has paid as primary on these accounts. > > INDIVIDUAL POLICIES > > >please help... > >if an esrd pt under the age of 65, has an individual commercial policy >that he purchased because he is self-employed, when pt becomes >medicare >eligible, will medicare become the primary or does 30 months >coordination-of-benefits still apply ? > >thanks- >catherine sioson >ny presbyterian hospital >new york, ny > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 13, 2003 Report Share Posted May 13, 2003 It has always been the practice that individual policies, where the insured has taken out their own policy without any EGHP involvement and pays their own full premium payment to the insurance company, are secondary to Medicare. I have never seen a case where Medicare wasn't primary over an individual plan. As far as the 30-month ESRD COB period is concerned, this only applies when there is an EGHP involved. So there is no 30-month COB period when the patient has an individual policy. Fred Forsthoffer, MBA Financial Analyst Banner Good Samaritan Transplant Services Ph: ; Fax: INDIVIDUAL POLICIES > > >please help... > >if an esrd pt under the age of 65, has an individual commercial policy >that he purchased because he is self-employed, when pt becomes >medicare >eligible, will medicare become the primary or does 30 months >coordination-of-benefits still apply ? > >thanks- >catherine sioson >ny presbyterian hospital >new york, ny > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 14, 2003 Report Share Posted May 14, 2003 I agree the key word is individual vs. employer/commercial or group. I have had several small business owners that have purchased a policy for themselves and once they added Medicare the Medicare became the primary payor. This ends up being real cumbersome when the pre-transplant work up is billed thru the commercial policy and once they are admitted for transplant (predialysis most cases) and they add Medicare and the primary insurance (and billing process) changes . Lori BondFinancial Counselor in TransplantLegacy Good Samaritan Hospital and Medical Center P.S. Welcome back, glad you all had a successful TFCA gathering in New Orleans. I look forward to working with all of you during this term. -----Original Message-----From: Babbitt, Diane Sent: Monday, May 12, 2003 3:04 PMTo: TxFinancialCoordinators Subject: RE: INDIVIDUAL POLICIES I was not at the conference, but our experience has been that if it is an individual commercial policy Medicare will be primary at the time of eligibility. The key is an individual policy/not a group policy. Medicare has paid as primary on these accounts. -----Original Message-----From: Sioson Sent: Monday, May 12, 2003 2:19 PMTo: TxFinancialCoordinators Subject: INDIVIDUAL POLICIESplease help...if an esrd pt under the age of 65, has an individual commercial policythat he purchased because he is self-employed, when pt becomes medicareeligible, will medicare become the primary or does 30 monthscoordination-of-benefits still apply ?thanks-catherine siosonny presbyterian hospitalnew york, ny Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.