RE: ?COB for ESRD pt with Individual Plan

[Guest guest]

It's my understanding, that Medicare is prime to an indivdual policy.

Pamela DeAnda, Financial Counselor

Cook Children's Medical Center

Patient Registration/Kidney Transplant

Fax

>>> jbucche@... 09/25/03 08:30AM >>>

I believe that there is a 30 month COB with ESRD patients with

individaul plans, but I just want to be sure. I know that Medicare

becomes prime in this situation with the disabled.

Thanks for your help.

[Guest guest]

It's my understanding, that Medicare is prime to an indivdual policy. [(Aguiar, )] I agree. My understanding is that Medicare is 2nd for the 30 mos COB ONLY if there is a group health plan involved, regardless of the size of the employer group (which is what would otherwise determine if Medicare was prime or 2nd). Medicare is primary for non-group policies & , of course, Medicaid, regardless of the reason for the Medicare eligibility. (I think there's a chart in the Resource Guide which probably spells out MPS in general clearer than I'm making it).

J. Aguiar

Beth Israel Deaconess, Boston