Talk of The Villages Florida - View Single Post - MEDICARE Fact or Fiction?
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Old 12-29-2023, 08:50 AM
Wondering Wondering is offline
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Originally Posted by APovi View Post
MEDICARE Fact or Fiction?
Is there is no way for a patient to know, in advance, if a 'treatment/prescription/therapy' is/will be covered by their Health Insurance?
Our friend got an unexpected invoice, so I called them for her.
I was told by the doctor, Medicare and the insurer that they cannot tell a patient, in advance, if a proposed medical expense is covered.
Apparently your medical provider submits an invoice to Medicare.
They decide which items they will pay.
Your insurer will only pay those charges which exceed what Medicare paid..
What we didn't realize is that, if Medicare says 'We don't cover that at all.' then your Supplemental Insurance doesn't either.
So, even with the best 'F' Supplement you're stuck with an unexpected expense!
Oh well!
If Medicare doesn't cover a doctor ordered procedure, then I question whether the procedure is legitimate or necessary. In addition, if your supplement doesn't cover the cost, the same rationale applies. So, what was the procedure, and what is the doctor's medical specialty?