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Originally Posted by APovi
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!
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So many people who are on Medicare plus a supplement believe everything is covered 100% if you have “the best” Medicare plan. That is not true. It is the responsibility of the patient to be sure a procedure,etc is covered. Also, contrary to the belief of these same types of people, not all drs take Medicare. Because you have “the best” Medicare that pays 100%, do your due diligence and be sure Medicare covers it. And before you see a dr, be sure they also take Medicare.