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Medicare Isn't Interesting -- As A Matter of Fact, It's Boring
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Medicare is
a government health program for people age 65 an older. It’s run by
the government so that means
it’s written in typical government style.
It’s all about rules and regulations and most people find it difficult
to follow and not very interesting.
Actually it’s boring reading, but necessary.
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The full regulations are found under the Code of Federal Regulation (CFR) Title 42 -- Public Health Chapter IV -- Centers for Medicare & Medicaid Services, Department Of Health And Human Services.
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Who Should Read The CFRs?
Now not everybody is interested in reading the CFRs, but at least your insurance representative should have a good handle on the regulations. What really amazed me recently are the insurance representatives that sell different Medigap policies or those representing the insurance companies who handle the Advantage Plans. Most of them have no understanding of Title 42.
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Recently we met with my husband’s representative for his Medigap plan annual review and the representative, who has been working for the company for about 1-1/2 years, had just found out about Medicare’s website and how you could sign-up on-line to view your claims and benefits. Wow, that surprised me.
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What I am leading up to, whether you are caring for a loved one, becoming eligible or are currently enrolled in Medicare, it is a good idea to have some knowledge of the “ins and outs” of the program or at least know where to find the information. Don’t rely on your insurance representative.
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Example
For instance, did you know that Medicare will pay for a motorized scooter if you meet the requirements outlined by your doctor? However, there are some Advantage Plans that will not pay for this type of durable medical equipment (DME) at all.
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Medicare is really great about outlining how a prescription should be written for diabetic supplies and services. But there is very little written about what is needed and how the prescription should be written for a motorized scooter or other durable medical equipment.
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Where do you find this information? You need to search the CFR, work with the equipment supplier and your doctor to get everything correct, the first time. For success, make sure all the “I’s are dotted” and “T’s are crossed” to avoid Medicare disqualifying the claim or you could be stuck with a $5,000+ bill for this type of equipment.
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Please feel free to contact me through this website if you have any questions or need help with Medicare.
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