My mom needs some help with a Medicare questionnaire she received in the mail.

[Occulus]

I'm dropping this in GD because I need the eyeballs. Any help on this question would be greatly appreciated. :)

The form says it is optional to fill out; however, if she doesn't, Medicare may be unable to properly pay for some treatments or procedures (I'm paraphrasing here).

The form has "COB" on the exterior of the envelope, "a CMS contractor". They give a website:

www.cms.hhs.gov/COBgeneralinformation

The Coordination of Benefits (COB) Contractor consolidates the activities that support the collection, management, and reporting of other insurance coverage for Medicare beneficiaries. The purposes of the COB program are to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken payment of Medicare benefits. The COB Contractor does not process claims, nor does it handle any mistaken payment recoveries or claims specific inquiries. The Medicare intermediaries and carriers are responsible for processing claims submitted for primary or secondary payment. To resolve your questions regarding whom to contact, see below:

There's also a phone number: 1 800 999 1118

Some of the questions on the questionnaire include:

Do you have a group health plan through your employer?
How many people work at your location?
Do you have a prescription drug plan available through your employer?

Other information:

Prescription Group number
RxPCN (I don't know what this number is; neither does my mom)
Member ID of her insurance through work
RxBIN (that one's a mystery as well)

And then, under "Special Information", from Section C of the form:

Are you currently receiving compensation for Black Lung disease, or other worker's compensation benefits?
Are you receiving treatment for an illness or injury for which another party could be responsible, or could be covered under no-fault auto insurance?

It's that last bit that raised a red flag to me; it sounds almost as if they want to build a platform on which they can later deny Medicare payment somehow. But, the form itself claims it is optional to fill out; I suppose she could fill it out in part, or not at all...?

Has anyone else received this questionnaire before? Is this something she should absolutely fill out and send in, or do you think I'm right, that it may be a way for Medicare to claim someone else is responsible for payment?

[democrat_06]

1. No need to worry...

The questions pertaining to auto insurance are standard. If you are injured in an auto accident, the auto insurance pays first before the medical/medicare insurance. If their is no auto coverage then standard insurance or medicare would pay. This is the way it always is. Insofar as the Black Lung question, there are payments that might be made first from a lawsuit trust before it kicks in.

Coordinating all insurance for medicare recipients is in theirs and the governments best interests. It assures that your mother pays as little as possible and that the government isn't paying for services which should be paid by private insurers.

[CTyankee]

2. I enrolled over the phone and they couldn't be nicer. You or she could call

their toll free number, 1-800-772-1213 after I couldn't get through to my local SS office. You DO get a live person and you don't get put on indefinite hold. Or at least I haven't and I've had to call a few times with different questions. I was dreading that first call, but I found that it was a very professional interaction with a very nice interviewer who answered all of my questions!

[Lint Head]

3. If you have concerns about filling out this document call

the phone number and ask very direct pointed questions. They are obligated to answer them and strive to be customer friendly.
If you have other insurance, then Medicare is secondary and another carrier may be responsible. Coordination of Benefits is just that. They are coordinating benefits. If a provider, durable medical supplier, hospital or pharmacy submits a claim to Medicare they need to make sure that each carrier involved pays the correct percentage. Medicare is administered by private insurance companies that bid for federal contracts
just like any other corporation. Black Lung is a special type of coverage that Medicare has to consider. I doubt your Mom is a miner that has been diagnosed with Black Lung but stranger things have happened.

Also this is the general number: 1-800-MEDICARE (1-800-633-4227)

Hope this helps.

[fishnfla]

4. I think they are attempting to determine any other insurance

which may superceed or supplement Medicare.

If she filed a claim thru Medicare and had this coverage unbeknownst to her, the claim would be denied

the "Rx" are
#'sused for prescription drug coverage

Edit to add: if she showed up at a Dr's office that didn't accept these secondary or supplemental coverages, she would have to pay 20% out of pocket, or if its an HMO she could be turned away

[Occulus]

5. Thank you; I'll pass that on to her

Probably a good idea to fill it out, I take it.

Thanks again! :)

[fishnfla]

6. Note

it could also be thru a spouse or formers spouses employment. Good luck

and thanks for taking care of your mom

[notadmblnd]

7. Not from medicare, but earlier in the week I received one from GM benefits

My husband was a GM employee before he died. My son and I receive medical benefits through GM as his survivors. I had to respond saying I had no other health insurance before they would pay any further benefits. but that was the only question I was asked, not whether or not I had any diseases or anything else.