In April, my mom was in a car accident and spent two days in the hospital. She recovered from the accident and its trauma, but the trauma of dealing with multiple insurance companies is ongoing (even though it’s September).
As explained in Chapter 18 of Become an Informed Caregiver: What You Should Know When Caring for an Aging Loved One, health care providers usually send their bills first to Medicare (which means Medicare pays first). They then send bills for amounts Medicare will not pay to the patient’s secondary insurance company or Medicaid, as appropriate.
But this isn’t always what happens, as we’re learning from mom’s accident. Medicare will not pay a medical bill a private company has already agreed to pay. Mom’s auto insurance included up to $1,000 of coverage for injuries she sustained in an accident. So until that money is spent, Medicare won’t pay anything to anyone.
After waiting months for someone to do something, the hospital and doctors sent their bills to mom. She has spent many hours on the phone with representatives from the auto insurance company asking, begging, and pushing them to pay out the $1,000. We think the company has finally done so, which means the hospital and doctors can finally send their bills to Medicare.
Has this ever happened to you? What were your experiences and how did you manage?