Wendy, as if we don’t have enough to put up with, now you owe money, there is no justice there. Sorry I can’t help but I’m glad that you warned everyone about your position. Cheers Barb
Sheila lives in Canada, though born in US
Hi Renie,
My primary is a Medigap/Part C insurance from UnitedHealthCare Complete. According to their billing department, my Medicare is secondary. I figured that if my Part C failed to pay it would automatically default to my part B of Medicare. Am I wrong thinking this??? Regardless, I think I found another doc in my area. I will be calling that office on Monday and on his website, he states he does take my insurance. Thanks for looking a little into this Renie!
hi PracticalMagic. I am glad you have not had any problems...yet. I just hear of more and more every week of people being dumped as the doctors decide they won't accept the terms of this or that insurance's new policies like just 3 weeks old policies. like SK said, I'm in Canada. Susan H's comment is one example.
2 Susans and 2 Wendys replying. Made me scratch my head. lol.
SK (Susan K), I was born in Canada, lived half my adult life in the states, then returned to Canada.
Yeah. My credit isn't so hot right now anyway because hubby and I declared bankruptcy about 7 years ago, so it can't get any lower that it is. So I am not worried about it. As for collection calls, we have caller ID for that. If it gets too bad, I will get some legal advice, but not right now. I am on a wait and see attitude for this. When I have been getting my account summary statements from UnitedHealthCare, not once did I see denied. Only when I looked online, I saw only 2 claims being denied and the rest are in a pending state. In my opinion, they aren't getting their money fast enough and are freaking out. Anyway, I may have found another pain doc closer to where I live and takes my insurance. I will call them on Monday and see what the deal is with him. He is an Osteopathic doctor and he does work with Fibro patients. As soon as I possibly can, I will be transferring all of my medical files from this PITA clinic to this new doc if I get the right answers.
While I do realize this is partially my own fault, they should have had in their system when I showed my insurance card that they did not take my insurance. This is such a nightmare, but I am a little toughie and I will get through this!
Thanks Wendy. Yeah, I know....my bad, but they should have figured this out weeks ago and not have put me through all of these appointments and piled on the treatments so that the bills would go higher and higher.
Hey everyone! I do worry about my two kids and what health insurance is going to be like in the future for them. They are in their 30's now. I was reading an article in a magazine I get every month called, ''Life Extension'' and it is predicted that by the year 2020, there will be a HUGE shortage of doctors and nurses, because of the way health insurance is developing now. I am more scared for my kids than I am for myself. Years ago, whenever I had to go to the hospital or have surgery, I was never frightened of anything, because I knew there would be good doctors and my insurance was wonderful. Now?? I am scared to death of having to go to the hospital. Not only for how much it would cost and what my insurance will pay, but also I have heard stories of people in the hospital getting staph infections, or their catheter was in them too long and they developed horrible infections OR ( and this is NOT unusual), Doctors accidentally leaving objects in their patients body after surgery Scary!! Laurie
OK Wendy, here goes. I hope I don't confuse you, I tend to do that to people!
Medigap is different than Part C. If it's a Medigap policy, it will ONLY cover after what regular Medicare Part B doesn't. It can't be used as a full medical policy, so it can't be your primary insurance. Your doctor would have to participate in Medicare Part B for you to receive coverage. If they participate, you wouldn't pay anything to them, except possibly a deductible or co-insurance depending on your policy.
If it's Part C, it would be a Medicare Advantage policy. That REPLACES your regular Medicare Part B, and would become your primary insurance. Unless you have another policy, for example under your husband, then it would be your only coverage, because Part B is no longer involved. Meaning: the doctor you saw would have to participate in United HealthCare for you to have any coverage at all. Your responsibility would be a set copay amount listed on your card.
If you do have an independent policy that isn't connected to Medicare, say coverage under your husband, that would be the only time Medicare Part B could become a secondary insurance.
Either way, when you made the appointment they should have told you that they don't participate. Or when you got there. Or when you were checking out! I would question the doctor's office why no one mentioned it, because someone there dropped the ball on this.
I'm glad you found another doctor, but in the meantime you're going to be stuck for what you've already had done. Plus I think they should have at least offered you the option to pay out of pocket for your future visits, instead of just cancelling them. I think you're going to be much better off away from this office!
Wow, that sounds really confusing...but I hope I've helped in some way!
Hugs!
Renie❤
Sheila W. be careful about what you hear is happening in the states while living in Canada. Ny husband is Canadian and we have are up in Canada a lot. I love to read/hear the news up there. Remember we are a huge population down here compared to Canada. So say you hear or read about people in Florida on Medicare, or you listen to Fox News, you get a few stories or advertisements. It is not the whole story. The only cuts in Medicare are to Medicare Advantage. It is a lousy program but it is a choice. It is a for-profit version which results in problems like Wendy is having. Nothing has been taken away from Medicare coverage, in fact things have been added. I live in New York state out in the boonies. No problems here. But we don’t have the political big wigs trying to scare us all either. Please don’t add to our anxiety about medical care. We are in transition with health care. It’s hard to get through but we will. Problems will get corrected. Until the mid 1960’s none of us in our states of disability or age had any insurance at all.
PracticalMagic
Thanks for info, sorry if I caused any problems.
Sheila
Thanks Renie, nope didn't confuse me at all. Your thoughts on the problem are the same as mine. Why didn't they say anything prior to making scads of appointments for me? Totally agree, someone dropped the ball on this one. This whole situation sucks monkey balls.
When I went to my eye doctor about a week ago, they asked for both my Medicare care and my insurance card. They did what the Pain Clinic should have done. They used my Medicare Complete coverage as much as they could and then went to Medicare to cover the rest. While I did have to pay for part of my frames and lenses, they discounted left and right for me after using both.
PM, I live in Massachusetts, so there are different rules and regulations concerning HMOs and my Medicare Complete program. I pay nothing out of pocket each month for my HMO just for my Part B. While restrictions are there, they were never an issue before. As I stated, I thought they would utilize all of my insurance possibilities. I even gave them my Medicare card when I gave my other card and they gave it right back to me saying they didn't need it. I went to other appointments with other types of doctors and gave them both cards and there were no issues whatsoever. So that is why I am so befuddled as to why they didn't do the same. Medicare does cover the Pain Clinic, so of course I assumed what my HMO didn't cover, Part B would.
Sheila, you did not cause any issues. It is a confusing scenario and you were trying to understand and help.
No worries <3
Thanks Wendy.
Sheila W you were being empathic. Just wanted to caution everyone about the abundance of misinformation about Obamacare. I often have discussions with friends and family in Canada - Ontario specifically - about the differences in health care and witnessed those differences as I take my MIL to the doctor. Several of them have lived in the US at various times. Personally, as I get older, I’d rather have Canada’s system.
Thank you so much everybody! You have all been a great support and a great source of information. Keep it coming!
I would not want Canada's system in a million years. I have friends with Lupus (a married couple, both have Lupus) who live in Canada.
She was just referred to a pain clinic as the meds she's on is not controlling her pain. The pain clinic put her on a "list" and told her it may be a year before they can get her in. A year?! She's in terrible pain!
Both of them changed Rheumatologists lately, as they were not happy with theirs. They not only had very few to choose from, but it took 6 months to get an appointment. They are both on chemo drugs, serious stuff, and had to wait 6 months for an appointment (my doctor sees me and does lab work every 2 months).
Finally, they are not happy with their PCP and would like to change. They are afraid to, as they said the wait would be so long (up to a year), and they are afraid to leave themselves uncovered for such a long period of time.
Our system is far from perfect, but I can change doctors at will, I can get in with a specialist within a few weeks, etc...
I live near the border,near the Ambassador Bridge, which carries people from Windsor to Detroit and vice versa. There are women and men from Canada who come over here and go to Detroit hospitals and pay out of pocket for breast cancer treatment and other treatment for life threatening illnesses because the wait times are so long in Canada. They are afraid they'll die before they get treated.
I'll keep my insurance, with premiums and co-pay and more out of pocket costs. Our system is far superior to Canada's (in most situations), in my opinion.
Sharon
One more question, I'm not sure if you already answered this, I can't find anything; did YOU get a copy of the denial from the insurance company? I just wonder what it says exactly the reason was. It may be that the office billed it wrong, so if you can get it corrected, you won't have to pay.
Renie, nope. No rejection paperwork as of yet. The only place I saw it was online. They only claims that they were denying were 2 of them. One because my old pain doc can't can't refer himself as a new doc in the clinic according to the billing department. The other, I am not sure as to why. But the others are in Pending status, so no out of pocket expenses as of yet. Since they are outpatient procedures for the most part, they may pay for them. If they don't, I will appeal it with my insurance company.