This is from the 2024 Geha Brochure.
When you are enrolled in Original Medicare along with this Plan, you still need to follow the rules in this brochure for us to cover your care.
This is from the 2024 Aetna Direct Brochure.
When you are enrolled in Original Medicare along with this Plan, you still need to follow the rules in this brochure for us to cover your care. Your care must continue to be authorized or precertified as required.
This is from the 2024 Blue Cross Brochure.
When you are enrolled in Original Medicare along with this Plan, you still need to follow the rules in this brochure for us to cover your care. For example, you must continue to obtain prior approval for some prescription drugs and organ/tissue transplants before we will pay benefits. However, you do not have to precertify inpatient hospital stays when Medicare Part A is primary (see Section 3 for exceptions).
Notice the 'however' comment in the BCBS brochure. That is telling. They've actually conceded they will waive the preauth for inpatient hospital stays. That leaves us to deduct that others are still in place.
This is why I asked about experiences because it does appear that when medicare is primary, FEHB is paying up no questions asked.
I'm still going with A&B primary and FEHB as secondary though based on what I've heard.
It is what it is!
When you are enrolled in Original Medicare along with this Plan, you still need to follow the rules in this brochure for us to cover your care.
This is from the 2024 Aetna Direct Brochure.
When you are enrolled in Original Medicare along with this Plan, you still need to follow the rules in this brochure for us to cover your care. Your care must continue to be authorized or precertified as required.
This is from the 2024 Blue Cross Brochure.
When you are enrolled in Original Medicare along with this Plan, you still need to follow the rules in this brochure for us to cover your care. For example, you must continue to obtain prior approval for some prescription drugs and organ/tissue transplants before we will pay benefits. However, you do not have to precertify inpatient hospital stays when Medicare Part A is primary (see Section 3 for exceptions).
Notice the 'however' comment in the BCBS brochure. That is telling. They've actually conceded they will waive the preauth for inpatient hospital stays. That leaves us to deduct that others are still in place.
This is why I asked about experiences because it does appear that when medicare is primary, FEHB is paying up no questions asked.
I'm still going with A&B primary and FEHB as secondary though based on what I've heard.
It is what it is!
Statistics: Posted by ljd46506 — Sat Apr 27, 2024 7:28 am — Replies 12 — Views 685