You are here: Home Government ... Medicare 101: An ... Medicare: Keeping ... If You Have Medicare And ...
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Medicare: Keeping Track Of Your Medicare Bills: A Simple Method

If You Have Medicare And Another Health Insurance Plan

Next » « Previous


If you are covered by Medicare and another health plan:

  • Read Medicare - Coordination of Benefits to understand how the coverages relate to each other, and which plan is Primary and which is Secondary.
  • Become familiar with, and start keeping, the forms you will receive from the insurance company and the Medicare payers:
    • Explanation of Benefits (EOB) is the statement you receive from the insurance company every time a claim is processed. It shows what the insurance company paid (or didn't pay) along with of brief explanation of how the decision was arrived at.
    • Medicare Summary Notice (MSN) is the statement the Medicare claims payer sends you when a claim is processed. It is very similar to an insurance company's Explanation of Benefits (EOB.)
  • Create a set of folders as described above. Then create two more folders:
    • One for bills that have been processed by the primary plan but not the secondary plan, with the primary plan's EOB or MSN.
    • One for the secondary plan's EOBs or MSNs until you can review them with the bill and primary plan's EOB/MSN to make sure they were processed correctly.
    • When both plans have processed the bill correctly, bind the bill, EOB, and MSN together and put them in your Completed Claims folder. If they're not processed correctly, as noted above, they go into the folder for questionable EOBS and bills.

Keep in mind that:

  • The secondary carrier will not process the claim until the primary carrier has completed processing it.
  • In addition to the itemized bill, the secondary carrier will require a copy of the primary carrier's MSN. Using the Five Folder System described above, you will be able to readily supply your secondary carrier with all of the needed information. You'll be able to keep track of what is happening with each company in your "Processed" and "Not Processed" folders.

NOTE: This system will work whether the second plan is individual or group and whether Medicare is primary or secondary.

Please share how this information is useful to you. 0 Comments


Post a Comment Have something to add to this topic? Contact Us.

Characters remaining:

  • Allowed markup: <a> <i> <b> <em> <u> <s> <strong> <code> <pre> <p>
    All other tags will be stripped.