Billing Insurance

Question:

Hi Jim. I have been 100% P&T for 14 years. I am 66 years old and I have Medicare and a supplement plan. Recently, I received a statement from my Medicare supplement plan showing that the VA billed my supplement plan for my treatment. The statement also shows that Medicare was billed and both Medicare and the supplement provider paid for this service. Up until this year, all of my VA care was covered by my 100% P&T disability. I don't understand why this VA is billing Medicare and my supplement provider. Thanks for any insights you can give me.

 

Jim's Reply:

This is nothing more or less than the usual sloppy bookkeeping done by VA. If you're 100% nobody should be billed. However, no matter what you do, VA is going to bill anyone on your list of insurers and hope they get a bite. 


Billing Medicare doesn't reap a payment, it just offsets the VA budget in a creative way. If your supplement carrier doesn't raise a fuss, VA will just take the money and never look back.


This usually happens when the provider you're seeing doesn't tick the correct boxes in the screen they're looking at so billing occurs because you have an insurer listed there.


There's little you can do. You can spend your time trying to find the responsible people inside your VAMC...lots of luck with that. You could tell your insurer but the last I heard of anyone doing that, nothing at all happened. Most insurers see it as the cost of doing business with VA and if it doesn't run into hundreds of thousands of dollars, nobody pays it any attention. Trying to correct mistakes at VA is like arguing with a stop sign...it usually goes nowhere.


My thought is, why do you pay for a Medicare supplement? I've never used one and can't see where there are any benefits to that...other than throwing money at another insurer. Those plans are expensive as heck and after the deductible and copay, I can't see a benefit? I have A & B as well as VA care and it's never been a problem.


Good luck sir.