How are claims paid if you have Medicare & Other Insurance?
other types of health coverage
Medicaid - Medi Cal
group health plan coverage
group health plan coverage after you retire
group health plan coverage for people who are disabled (non-ESRD disability)
group health plan coverage for people with End-Stage Renal Disease (ESRD)
no-fault or liability insurance
Federal Black Lung Benefits Program
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Benefits Coordination & Recovery Center (BCRC)—
The company that acts on behalf of Medicare to collect and manage information on other types of insurance or coverage that a person with Medicare may have, and determine whether the coverage pays before or after Medicare. This company also acts on behalf of Medicare to obtain repayment when Medicare makes a conditional payment, and the other payer is determined to be primary
Dual Coverage Questions from a website visitor
Answered in Interlineation
My wife (I have full authorization filed for disclosure) is 69 and coverage by traditional Medicare (A and B) and also has group health insurance under a group of less than 20 employees.
***Thus Medicare pays first.
She had an accident and fractured her teeth requiring implant and new porcelain/ceramic pontics.
***Thus Medicare would pay for an accident, but not routine dental.
Claims were submitted to BCBS of Florida who says we should have first submitted the claim to Medicare.
***That’s correct, as Medicare pays first, then your group plan picks up the rest.
I have already paid directly for the services.
We reside in Florida and there were two D.M.D.’s (Doctor of Dental Medicine – same as DDS) involved in providing the services.
What do you recommend?
***I suggest that you just send the bill to Medicare. Then resend to your group plan, once Medicare has paid.
(Also, when we look at my wife’s profile online
***Do you mean her Medicare profile? www.MyMedicare.Gov?
it doesn’t list the supplemental carrier at all. How to we correct that?
***Send me your password privately and I’ll figure it out. Medicare also has a customer service and live chat on the website. They should be able to help you.
Notice about Medicare secondary payer subrogation rights
We have the right and responsibility to collect for covered Medicare services for which Medicare is not the primary payer. According to CMS regulations at 42 CFR sections 422.108 and 423.462, Anthem MediBlue Access (PPO), as a Medicare Advantage organization, will exercise the same rights of recovery that the Secretary exercises under CMS regulations in subparts B through D of part 411 of 42 CFR and the rules established in this section supersede any state laws. Anthem MediBlue Access (PPO) Evidence of Coverage
Medicare & other types of health coverage
Medicare & Medicaid
Medicare & group health plan coverage
Medicare & group health plan coverage after you retire
Medicare & group health plan coverage for people who are disabled (non-ESRD disability)
Medicare & group health plan coverage for people with End-Stage Renal Disease (ESRD)
Medicare & no-fault or liability insurance
Medicare & workers’ compensation
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Medicare & the Federal Black Lung Benefits Program
Medicare & COBRA