[Previous Months][Date Index][Thread Index][Join - Register][Login]   Help@Insulin-Pumpers.org
  [Message Prev][Message Next][Thread Prev][Thread Next]   for subscribe/unsubscribe assistance

[IP] Anyone have Medicare as a 2nd insurer? Very long but important$$$$$

Medicare is my second insurance.  I have a MM 508 currently and have been 
 pumping for over four years. Even though my first ins. covers almost
being that Medicare is involved as my second ins. and that Minimed is a 
Medicare provider, I must always follow Medicare procedures when I deal with 
 Minimed for supplies, pumps etc. This is very annoying because as some of you
Medicare has you in circles with forms and rules.  I could drop my first ins 
which is expensive and pays well to Minimed and then Medicare would be primary 
and have to shoulder more of the cost than they have to do now as a secondary 
and I am sure that Minimed would get less from Medicare in the long run.  I 
have kept both figuring that two insurance's are better than just Medicare.  
 When I ordered my pump a few months ago from Minimed, they told me that
did not do coordination of benefits and therefore I would not be responsible 
for whatever balance was left after my first insurer and they made me sign a 
 paper saying I would pay the difference before the pump went out to me. I told
them that if after both ins. Medicare told me I owed something, I would pay.  
I received an EOB from Medicare telling me that they approved nothing but I 
was not responsible for any payment because the equipment is covered only if 
 rented and that I should not be billed for this service and that I did not have
to pay this amount which was the original price of the pump before the first 
insurance got involved.  There is a charge on my Minimed statement for the 
remaining 20% after my first ins. paid 80% of the agreered amt..  I spoke with 
 Medicare Durable Goods people and they confirmed that Medicare only rents pumps
not purchase them.  Medicare as a secondary insurer requires me to go to my 
first insurer first.  My first insurer only purchases pumps.  Medicare Durable 
 Goods people told me that if I am charged for the 20%, I am to send an appeal
to them with a letter from my first insurer stating that I could not rent one 
from them that only a purchase could be made.  I have this letter and have 
 sent my Medicare EOB which Minimed said they received no copy form Medicare,
this letter to Minimed to see if they will drop the 20% charge.  Has anyone 
ever had this problem?  I can't imagine how Medicare can deny any payment on 
 this because I did not rent it, when it is Medicare who makes it mandatory I to
go to the first insurer and that first insurer does thing differently than 
 Medicare and them Medicare will not pay because of that. Something is not right

for HELP or to subscribe/unsubscribe, contact: