My Father is in his 90’s and a Veteran. My Father has VA insurance and Medicare. VA is suppose to billed first. This has occurred on 2 separate occasions at different hospitals. These veterans are instructed in an emergency to go to the closest hospital. After the incident they receive bills for their portion. During admissions etc. both their VA and Medicare information are provided. When I call and question each organization has indicated by default if Medicare is there they bill Medicare. We have been clear up front on this process. My Father thinks they get more money going this route. Most elderly are overwhelmed and I am almost certain just pay bills, when I got involved one had even been sent to collections. This almost feels like elder abuse.
I believe if an audit were performed on these organizations this would show a big problem. How does this get raised to the right people? Think this is more of a Clark attack thing then a question, after all my Father has me but how many don’t have someone!
Reading Page 26 of the above link… We see why the Hospital prefers Medicare. Seems they they get more and I might add it is a procedure they are far more familiar with.
My question is… Is he required to give both VA and Medicare Info.
Sounds like he has a choice. The way to ensure that his choice is honored is to only provide one or the other.
Can the Hospital demand Medicare Info… that is the question?
The VA has to go first as they do not pay co pays. I am sure the hospitals know they get more from Medicare. This puts stress on Seniors and in my mind is criminal. How many VA elderly out there pay the bill and in effect being robbed. I say this because I have been the one calling and this is what I have been told. Having been in IT for 30 years my educated guess is they choose not to correct this issue. I believe until penalties are greater then the monies collected they will not correct their systems. Some type of auditing needs to occur then penalties set to push them to correct their processes.
To be clearer, "Sorry did not directly answer your direct question, I do not know if they can demand Medicare or not, but I do know the cost after the VA pays first, remainder to Medicare second, the amount falling to insured will be less. If sent to Medicare first the VA indicates they do not cover co pays. Recent broken hip charges paid $80,000 with $1,500 to my father. Called and was told despite giving both insurances and instructions I can ignore the bill and they will re run correctly. How many just pay the bill? The person on the phone was able to see both cards in their system with a suggestion to call afterwards…
Does the VA insurance include copays that your father would be required to pay, or are there no copays? It was not clear to me. I know medicare has copays, and the VA will not pay those.
It seems like he should only give them his VA insurance information, and once that is billed, if any services are denied, he should then ask that they file those with medicare, and give them medicare insurance information at that time.
In dealing with family members using civilian health care I have more than once had to explain the difference between VA medical and Tricare. Most facilities are familiar with Tricare, know that it applies to military veterans and assume it to be the same as the VA about which they are not as informed. It also doesn’t help that Tricare is the secondary payer when the patient has Medicare so not really surprising when they bill the VA as secondary payer also. I’ve never had any problem getting things rebilled correctly.
Anything left after the VA is sent to Medicare. It has taken so long for them to process, not to mention my Father thru up his hands I have to wait to see the results. Definitely if any come back and Medicare does not pay on the secondary he will owe. The whole business of waiting to send to Medicare when they can bill correctly in the first place but choose to not is what I am really bringing up, should not be an elderly’s problem , feels akin hooping they give up and should be held accountable. Each phone call they apologize and indicate to ignore the bill they sent and they will reimburse Medicare and run the bills correctly. They know the problem …how many people are elderly and taken advantage of in this situation without realizing.