05-25-2012, 10:16 PM
I think the first step is determining what coverage they do have. the KHPE could very well be a Medicare Managed Care plan, aka Part C, so they could have "one insurance" plan. they should also have a Part D plan, for prescription drug coverage. So they may have 1, 2, 3 or more different Medicare related coverages.
Medicare "supplemental" insurance is a very specific meaning, and is sold as an alphabet soup of standardized plans. Each letter plan has different coverage, but the overall coverage is limited (to what is generally known as the cost sharing aspects of traditional medicare.
Medicare Managed Care, Part C, changes all of this, and by signing up for a private for profit managed care, they will get a different benefit package, and may have different cost sharing or benefit limits.
The 2nd step is determining whether Medicare is actually covering this care, or not, and if the bills are for "cost sharing" for medicare, or not. The EOB for Medicare is known as an ABN (advanced beneficiary notice) so the hospital should have provided that.
Medicare "supplemental" insurance is a very specific meaning, and is sold as an alphabet soup of standardized plans. Each letter plan has different coverage, but the overall coverage is limited (to what is generally known as the cost sharing aspects of traditional medicare.
Medicare Managed Care, Part C, changes all of this, and by signing up for a private for profit managed care, they will get a different benefit package, and may have different cost sharing or benefit limits.
The 2nd step is determining whether Medicare is actually covering this care, or not, and if the bills are for "cost sharing" for medicare, or not. The EOB for Medicare is known as an ABN (advanced beneficiary notice) so the hospital should have provided that.