Hospital and Insurance Billing
Information about Your Medicare Coverage
Patients who qualify for Medicare will have one of the plans below. Programs do not overlap.
Medicare Part A: Provides coverage for inpatient hospital services.
Medicare Part B: Provides coverage for outpatient services, emergency services and inpatient diagnostic services.
If a patient has Medicare supplemental coverage, the hospital will automatically bill for the deductible or co-payment. A patient should present their most current insurance card for the supplemental insurance at each visit to the hospital. If a patient does not have Medicare supplemental coverage, they will be billed and are responsible for the deductible or co-payment.
Medicare Advantage (HMO)
Medicare Advantage replaces traditional Medicare coverage and is not a supplemental plan. For information on this type of coverage, patients should contact the number provided on the back of their card. Medicare Advantage is provided through multiple insurance carriers. After the Medicare Advantage Plan has paid its portion of the bill, the patient will receive a bill for the balance due.
Senior HMO’s are provided through the following carriers and are billed in place of Medicare.
- Blue Cross/Senior Secure
- Secure Horizons (PacifiCare)
- Seniority Plus (HealthNet)
After the Senior HMO has paid its portion of the bill, the patient will receive a bill for the balance due.
Providing Additional Information to Medicare
If Medicare requires additional information in order to process a claim, only the patient can update this information. Medicare can be contacted at 1-800-999-1118 to provide the additional information or to verify coverage.
Advanced Beneficiary Notices (ABN)
The hospital gives Medicare patients Advanced Beneficiary Notices prior to receiving non-covered Medicare services. This notice states that Medicare will not pay for some treatment or services. The notice is given so the patient may decide whether to have the treatment and how to pay for it.