Medicare question

I went on Friday to DWL  information session. Does anyone know if it is hard to get approval from Medicare? I have Secure Horizons underwritten by UHC. They wouldn't tell me if it would be covered or how much they would pay if they did. At the information session the insurance person said that I would be responsible for 20%. So at $36,000 I fiqure that I would have to pay about $8,000 plus all the upfront stuff for psy, nut, enrollement. I have been to several other information sessions in the past few years and you had to pay the hosiptal your estimated amount upfront.  Friday they said that at Durham Regional that you do not pay the hospital upfront, they will bill you. Any input , experience would be appreciated

They can only charge you 20% of the contracted rate w/ the insurance. Like say a surgeon charges $5000.00 for the RNY surgery but the contract rate is only $2000.00 all they charge you is $400.00.  Also if you have Medicare, they do cover surgery all of them. It is my understanding you do not pre-cert anything so it's up the surgeons office to have all the I's dotted and T's crossed so that when it comes time to file the claim the surgeon gets paid. Good Luck!

I also have Secure Horizons Medicare Complete Choice PPO underwritten my UHC. I did have to have my "package" submitted to UHC by DukeWLS. It took about 2 weeks for them to approve the surgery. Mine has a $3900.00 annual cieling, so there is know way that it will cost more than that. And remember that the co-pay that you would be charged is based on the medicare approved amount, which is much lower than whatever they normally bill. I haven't received all of the bills yet ... I'll let you know how it goes.

Barb

Thanks for the info. So you didn't have to pay the hosiptal in advance of your surgery? At Baptist and Cone they require that you pay in advance to the hosp. That would be better to pay afterwards, then have some idea, have to get a personal loan I guess.