How do you finle a Medicare claim?

Question

My dad uses the Veteran's Hospital for all doctor visits, and in the past they had paid all his medical expenses. Lately we have been billed for some things, and I had been paying them, but I thought maybe Medicare should be covering what the VA doesn't. I don't know how to file this.

I really appreciate all these responses! My dad is 91 and in good shape, but he does need a lot of help, and I'm the only one who can do it. He was in the Army for 7 years, and though the augiologist believes his hearing loss is a direct result of his combat duty, he has never received any disability. He has in excellent health - he's just getting older -so his visits to the VA have been few. Thank you all for this very helpful information!

Answer 1

The VA shouldn't be sending a bill for anything. The only possible way that could happen is if your father has been receiving care and was not considered to be a veteran with service-connected disabilities. If his total income is above a certain amount he would then be determined to be ineligible for further care and might be billed for care received after the law was changed. It's called being in Category Eight. I live about three blocks east of a VA clinic and can't be seen there because I make too much money. Fortunately I have Medicare and Tri-Care For Life (through my military retirement).

Answer 2

If you file with the VA - then forget about Medicare! You cannot bill the Govt. twice. However, if your Dad worked outside of the Military for at least 10 years (or 40 quarters) then you might be able to collect from Medicare ONLY! They typically pay 80% of the bill. Call - 1-800-MEDICARE
- they'll tell you how to go about it! CJ

Answer 3

It may be possible for you to file Medicare for your father. The VA should have done that but a lot of doctors don't like to bother with Medicare as they don't get much money and the time it takes from filing to receiving something is a long time.

Answer 4

With Medicare, the health provider [VA/Doctor/hospital] files the claim...not the Medicare recipient. SOME times Medicare does not pay the entire bill; hence you receive a bill for that...that bill should note what Medicare did or did not authorize payment.

Answer 5

First of all, does your father even have Medicare? If he does, then the hospital/dr must submit the claims to Medicare. He would be responsible for the co-pays & deductibles, though. If he doesn't have Medicare, then contact Social Security, in the phone book, to see about filing for Medicare.

I have Medicare & don't always get the 'Explanation of Medicare Paid' statement which shows what they've paid or not paid & the reason why. So if he has Medicare, you can contact them and ask for the stmts.

Answer 6

IS YOUR DAD A RETIRED VET? SHOULD BE TRICARE MEDICAL FOR RETIRED MILITARY AND MEDICARE IS FILED BY THE PROVIDER OF THE SERVICE