This is a direct quote from a really helpful person in the Medicare organization who was trying to help me sort out something that has happened to my Medicare insurance coverage.
First of all, I would like to express my appreciation for the nine employees of the Veterans Administration and the Medicare Agency of the US Government who attempted to assist me during my two and a half hours of phone calls today. Every one of them was unfailingly polite, even if they did not have information that would help sort out my problem.
I am relating this story in the hopes that it will amuse and also that someone else may have encountered this and resolved it somehow.
I have been receiving Medicare payments against my medical bills for several years. I am very happy with the coverage that I have received up to a few months ago. I am thankful to the elected officials whose efforts made this all possible. I don’t need medical coverage very often, but it’s nice to know that Medicare is there when needed.
Until a few months ago…when I received a call from one medical provider that my treatment was not being covered by Medicare because I had other Primary Insurance Coverage. Hello?? I have not had any other medical insurance for years! Where was this coming from?
I called the medical provider and said I had no other insurance. They gave me a Medicare number to call and I did. I was told they would look into it and get back to me.
I took my attention off this because Medicare was still paying claims from other medical practitioners I was using. It seemed as if it had somethng to do with this particular medical practice and I thought no more about it.
Fast forward a few months and I receive bills from my favorite local medical practice that show that Medicare is no longer paying toward my medical expenses because of an existing "Other Insurance Primary".
I make a few calls and find that this other Primary Insurance Coverage is supposedly provided by the VA! I am sure I don’t have any VA insurance because my military service from 1957-1963 was spent mainly in the Active and Inactive Reserves.
I call Medicare and get no relief because the first few people I contact say they can do nothing and that I have to talk to the Veterans Administration. I call four or five people in the VA until I get someone who actually looks me up in the system and says, "I can find no record of you at all. You are not in our system."
So, back to Medicare again and I call a couple of people until I find a woman named Tammy who actually looks up my Medicare records and asks lots of detailed questions. Then she goes off and asks someone else for help and asks me more questions. She tells me that this Primary Insurance Coverage started in 2003, so I ask why hasn’t it shown up before this? She doesn’t know.
I ask, "If I have this other insurance coverage from some unknown source, how do I contact them to get them to pay up? Also, how come Medicare is paying on my other medical claims? Why only this provider?"
She looks at my Medicare records some more and laughs. "This is the most bizarre scenario I have ever seen!"
She is sending the report to the Medicare Benefits Coordination group and I should hear from them in two business days.
It will be most interesting to see what turns up. I will keep you posted.
Has anyone else encountered this situation?