Medicare versus GEHP Issue

[Guest guest]

I just talked to an insurance company that states that if a patient is Medicare

Prime based on ESRD, that the primary status of coverage for Medicare is only

for ESRD services. All other medical or surgical services non ESRD related are

still primary with the GEHP. Is this true? My understanding is that when

Medicare becomes prime, Medicare is prime for all services. Is there any

supportive documentation either way? Your help would be appreciated.

Julius C. Eason

Transplant Financial Coordinator

Multi-Organ Transplant

Beaumont Hosp., Royal Oak

(P) , (F)

jeason@...

[Guest guest]

When Medicare becomes primary, it is primary for all Medicare-covered services, regardless of why the beneficiary became eligible. If pt did not enroll in Part B, some payers will continue to pay primary for those services, some will not. There are reams of info on Medicare COB - perhaps this issue is addressed in Who Pays First?

http://www.medicare.gov/publications/pubs/pdf/02179.pdf

on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@...

-----Original Message-----From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]On Behalf Of Julius EasonSent: Monday, September 27, 2010 9:06 AMTo: tXFinancialCoordinators Subject: Medicare versus GEHP Issue

I just talked to an insurance company that states that if a patient is Medicare Prime based on ESRD, that the primary status of coverage for Medicare is only for ESRD services. All other medical or surgical services non ESRD related are still primary with the GEHP. Is this true? My understanding is that when Medicare becomes prime, Medicare is prime for all services. Is there any supportive documentation either way? Your help would be appreciated. Julius C. EasonTransplant Financial CoordinatorMulti-Organ Transplant Beaumont Hosp., Royal Oak(P) , (F) jeason@...