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For example, my previous insurance covered my test strips 100%, and the insurance company required me to use a mail order company. Okay, so Medicare also allows me to use this same mail order company, but if they only pay the first 80% and my old insurance company pays the remaining 20%, what happens if I haven't yet paid Medicare's $140 deductible? Since my insurance covered 100% of the test strips with no co-pay or deductible, will my old insurance company pay for the strips?
Next, since Medicare doesn't pay for vaccines or immunization shots and my old insurance company does, then when I got a tetanus booster in September, and Medicare refused the claim since they don't pay for immunizations, shouldn't my old insurance cover it, even though I haven't met Medicare's $140 a year deductible? I mean, a tetanus shot isn't covered by Medicare so it shouldn't be included in their $140 a year deductible, so my old insurance company should pay for it.
Then if Medicare has a $140 a year deductible and I started Medicare September 1st, does that mean that I only have to pay the first $140 of any medical bills and after that $140 is paid, then I don't pay another deductible until Sept. 1st of next year, or does the insurance start all over January 1st? That doesn't seem right....to pay a $140 deductible that starts Sept. 1st, then 4 months later (Jan. 1st) I have to start all over and pay another $140 deductible for the new year.
I know, you'd think that I could get the answers to these questions by calling 1-855-800-8227Medicare and my old insurance company, but it's not that easy. See, when you try to contact 1-855-800-8227Medicare, you get get put on hold by their automated answering system, then if you do manage to get through, you get shuffled around until they finally tell you that you need to contact your insurance company.
Then, the insurance company puts you on hold, then transfers you around until they finally tell you that you need to call 1-855-800-8227 Medicare. You just get fed up and you give up. I figure that I'll find out when the bills come in.
Is it possible that you are making more income than you think you are? Medicare premium is usually taken out of your check when you get Social Security or disability. Medicare premiums average $109-$134 per month so if your check has a premium deducted and the income you receive is $803 AFTER Medicare is taken out, then you might actually be making more than $885 per month ($803 plus $109 is more than $885). If the premium for Medicare is being paid for you by the government because you are low-income, the cost of the Medicare premium may be added added back into your "income" calculations for your state as a benefit and it makes you not eligible (there is NO PARTIAL eligibility for Medicaid - it's yes or no). Try a disability lawyer if the DCF offices are not explaining your situation to you - they file claims all the time. If you are not eligible, a disability attorney's office will know why very quickly.