Saturday, September 15, 2007

Medicare - Tilting at Windmills

I was pushed into retirement four years ago as my company was cutting costs and trying to increase profits. In hindsight I was very fortunate. The package was generous, I had turned 62 a week earlier, and my son looked at my finances and told me I would never have to work again if I did not want too. Two weeks later, my wife found her lump and we began what was going to only be a four year battle with cancer. Part of the package was a buy into the company medical plan for the two of us. A year ago when I turned 65, my wife went on a single plan through the company until she turned 65 or 18 months whichever came first. The cancer came back with a vengeance this past December. My wife turned 65 in July so Medicare B kicked in July 1st. Medicare A kicked in when MS caused her to be disabled a number of years ago. The company carried her until July 31st. The Medi-gap policy when into effect August 1st.

Herein was the problem, when the hospital and the nursing home billed Medicare, Medicare said Blue Cross was primary and of course Blue Cross said Medicare was primary. Both billing parties called me. I then began my quest with Medicare Coordination of Benefits. The first person who answered said I must put my wife on the phone to authorize me to speak for her. I explained that she passed away. She said, "I don't know that, I must protect her privacy". I was told that I would have to fax in a death certificate. I did that the same day and wait a couple of business days. So I did and got another person who once again said, I don't see a death certificate. I sent it. well it takes several days for it to be entered. I told her that the government could listen to my phone calls without a warrant, delve into my Internet wanderings and invade my privacy, but you won't help me clear this payment issue up. That's right. So I waited and called several days later and this time a wonderful woman answered. I explained my situation, she told me that the death certificate was not entered yet but she could help. She said she could see that the monthly social security benefits were stopped and that she had a different view of the privacy laws. She then asked a few questions and I listened while she keyed for several minutes. She finished by telling me she was sorry for my loss, and that I could tell the hospital and nursing home to wait 15 days and resubmit and that medicare was now primary and the bills would be paid. I told her she was an angel and a burden had been lifted off my shoulders.

1 comment:

Jill said...

Hey. Just wanted you to know I was here. Nice talking with you this afternoon. I got home a little after 8 and then put one, two, three kids to bed. Then I blogged for about 1/2 hour and I just finished. Woohoo. A little "me" time. Love you.