A seventy year old client phoned me to ask why she was being billed for $124.10 when she had both Medicare and a Medicare supplement insurance policy through our insurance agency. I asked the client for some details and then phoned her insurance company to get more details from it.
The client got medical services in early February of 2011. In 2011, the Medicare Part B annual deductible is $162. That means that when a person on Medicare uses a doctor, clinic, laboratory, or other outpatient medical service, the first $162 of Medicare approved Part B claims is the patient’s responsibility. After that first $162 is met, then, Medicare and the patient’s Medicare supplement insurance policy pay on such claims. But, the first $162 is the patient’s responsibility. In-patient hospital services are covered by Medicare Part A and have a different deductible amount.
By federal law, Medicare supplement policies are standardized to help senior citizens avoid confusion and compare coverage from various companies more easily. Medicare supplement insurance companies compete for business with rates and service. A STANDARD PLAN F policy from one insurance company will pay exactly the same as a STANDARD PLAN F policy from another insurance company. The STANDARD PLANS cover none, one, or both of the Medicare Part A and Part B deductibles. The more annual deductibles that you want to be covered by a Medicare supplement policy, the higher the rates will be because the insurance company will pay the deductible under the terms of the insurance contract.
This insurance agency is contracted with about two dozen insurance companies for Medicare supplement insurance. This allows our agents to review a client’s health and financial ability in order to match the client with the most affordable rate for the type of STANDARD PLAN policy that the client wants. We believe that this is a better way to serve senior citizens.
In the case of this client, she had a policy that did not cover the Medicare Part B annual deductible. She could have bought a policy that did cover the deductible, but such a policy would have cost more money. If she told her insurance agent that she wanted to keep the monthly premium low, then it would be natural for an agent to suggest the policy that she bought.
Note: Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana. That agency has an office in Schererville, also.
© 2011 Woodrow Wilcox