What to Do When Medicare Won’t Pay for More Tests

LinkedIn

“How can Medicare (and how dare Medicare) determine that I’ve had ‘too many tests’?” asks a reader at The Los Angeles Times blog Bucks. “Medicare has informed me that I’ve had ‘sufficient’ tests this year and that they won’t pay for any more.” If you’re caring for an aging parent and this issue comes up, here’s part of what Medicare expert Joe Baker advises in the blog post:

It may be that you received duplicated tests or that you have reached the limit of what Medicare deems medically necessary. In any case, you always have the right to appeal a denial of coverage or payment. If you have Original Medicare, you will see instructions on how to appeal on your Medicare Summary Notice. If you receive Medicare through a private health plan (commonly known as “Medicare Advantage” plans), you must first obtain a written denial from your plan. The denial should include instructions on how to appeal. Whether you have Original Medicare or Medicare Advantage, the key is to demonstrate, through a letter from your doctor, that the tests you received were medically necessary.

Baker’s full answer appears in part two of his recent Medicare questions-and-answers posts at Bucks. In this installment, “Answers About Medicare: Part 2,” he also addresses what to consider when you turn 65 and what to do when you want to see a doctor who doesn’t accept Medicare.

If you have any questions about this post or need help finding senior-care options for a loved one, call 1-866-483-4896 to speak with a care advisor in your area.

LinkedIn
Posted in Medicare, Medicaid Tagged with: , , ,
0 comments on “What to Do When Medicare Won’t Pay for More Tests
1 Pings/Trackbacks for "What to Do When Medicare Won’t Pay for More Tests"
  1. [...] The New York Times has been featuring in its blog Bucks. We previously covered parts one and two. Here are installments three and four. Possibly related posts: (automatically generated)4 Ways the [...]

Leave a Reply

Your email address will not be published. Required fields are marked *

*

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>

Speak to a Care Advisor

Do you want to speak to a care advisor? Fill out the form below.

* These fields are required.

Follow us on Twitter!

#ElderCareChat

Subscribe to our blog

* These fields are required.

About Us | Blog | Link To Us | News | Jobs | List Your Community | Contact Us | Terms of Service | Take Down Policy | Privacy | Site Map
Copyright © OurParents 2014