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Old 07-18-17, 12:25 PM  
videofit
 
Join Date: Dec 2002
Medicare billing when someone has other insurance

My elderly aunt was having back pain, got no relief from her chiropractor so I took her to mine who 'fixed' her. My chiro doesn't accept insurance, you have to chase down the insurance company for reimbursement. It's always annoying dealing with any insurance then toss bloated government bureaucracy into the mix. According to my aunt, her doctors bill Medicare first and then any amount they won't pay gets forwarded to her insurance company. It's an automatic process.

I've looked at AARP and Medicare sites and can't find information on how to submit to Medicare. I worry that if I send the bill to her insurance company first it will be kicked back. I don't want her to pay out of pocket as she is on a fixed income.

Anyone ever have this experience?
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Old 07-18-17, 12:53 PM  
Joni O
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Does she have her Medicare paperwork? There should be instructions there. Or look at her Medicare card and call the number. You'll need her Medicare number to talk to anyone and it should be her SSN followed by an A.
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Old 07-18-17, 01:25 PM  
danielsc
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If Medicare is her primary and the doctor does not accept Medicare there is nothing you can do to get payment. Her secondary policy follows what Medicare does so if Medicare does not pay neither will AARP.
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Old 07-18-17, 02:07 PM  
luvcritters
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Medicare.gov/medicareonlineforms and get form CMS-1490S. Instructions will be with the form. If you need more help, call 1-800-MEDICARE

If this is a recurring problem for which she goes regularly, they won't pay. If this is something that just happened they usually pay. Did her original chiropractor file Medicare?

EDIT: It must be medically necessary to correct a subluxation. You pay 20% of the Medicare-approved amount. That may be picked up by the other insurance.
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Old 07-19-17, 10:58 AM  
rosepetals
 
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I have medicare and a secondary insurance. When you go to the chiropractor you need to make sure they accept medicare. They will bill medicare, not you. They do it automatically. After medicare pays then it is sent to the secondary company. I haven't had to pay anything for chiropractic care.

Not all chiropractors accept medicare. One wanted to sign me up for a contract that would make me going 3x a week instead of when I needed it. Be careful with who you pick.
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Old 07-20-17, 05:41 AM  
Carol K
 
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videofit said that her chiropractor does not accept ANY insurance. That's why they didn't bill Medicare themselves. I have never heard of a patient sending a claim to Medicare directly and receiving payment from them. And I would think the supplemental insurance would require that the claim go to Medicare first.
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