Insurance Question

Good Morning! Would like to know who has been approved through Humana and what was the wait time? I know each case varies. Was it fairly easy to get approved? I actually have medicare and Humana as secondary. However, for some reason, the Dr. office is going directly through Humana. Any feedback will be appreciated. Secondly, any feedback on what Humana's precertification entails? Thanks Charlotte B.

Charlotte welcome to the board first off. i would imagine they are going thur Humana first to try and get approval as they will pay more and then Medicare will pick up what is left. Medicare only allows them to charge a certain amount and they are left holding the bag , so to speak for the parts that arent covered after you pay your part too. So if they can get you approved thru Humana they will come out better financially . What doctor are you using? Even if your other insurance doesnt cover it at all medicare will pay for it . just not as much as Humana will pay. Jan

Charlotte, Are you sure your Humana is sceondary to Medicare and has not REPLACED you Medicare? I'm in billing and Ins in a medical clinic and the NEWEST Humana (Humana Gold- Medicare fee for service) is actually replacing Medicare, it's not a supplement to Medicare. Nearly every one of pur pts with the policy thinks it's their secondary, it's NOT. On your card, if it says something like "do not file with original Medicare" that's because it's a replacement for it. You would find this in VERY small print probably on the back of your card. This whole deal is very confusing and Humana has not made it clear, oviously, when they are sellign their plans. Just thought I'd share this with ya as it MAY be why they are going through Humana first.

Jan and Tamara, Thanks for the response. I think I will call my Humana Rep. This is so confusing to me and of course I am getting nervous now cuz I really need this surgery for my pain etc. Tamara - No, it doesn't say anything on the back of the card like you asked me to look for. Thanks to both of you for your input. Guess I had better ck. this info out. Love the board and all you wonderful people. Hopefully soon I will be letting you guys know that I have a date with surgery! LOL Hugz, Charlotte