You may also have a "Medicare Supplement Plan" purchased
through a third party. If so, your policy may cover medical services
that Medicare does not.
Forms for Medicare patients
Certain forms are specific to Medicare patients and may be new to
you. These include:
- Medicare Secondary Payer Questionnaire—all patients
- Hospital discharge information (called "An Important
Message from Medicare")—inpatients only
Beneficiary Notice of Non-payment (ABN)—outpatients only
Medicare secondary payer questionnaire
For many people, Medicare is their only insurance policy that covers
medical services. However, sometimes more than one insurer is
responsible for medical bills. In this case, the "primary"
insurer is the insurer who is billed first, and the
"secondary" insurer is billed next. For example, if you are
injured in a car accident, auto insurance pays first, then health insurance.
Medicare uses the Medicare Secondary Payer Questionnaire to decide
if they are the primary or secondary insurer. You will fill out this
form at each visit.
Health care providers who accept Medicare are required to use this questionnaire.
Questions about Medicare secondary payer
For any additional questions you may have, please contact
- Medicare: 1-800-Medicare (633-4227)
- Coordination of Benefits (COB): 1-800-999-1118
Your rights at hospital discharge ("Important Message from Medicare")
This form explains your rights, as a Medicare patient, at hospital
discharge. It includes information about the appeals process if you
feel you are being discharged too soon.
You will receive this form twice, at admission and discharge. The
Centers for Medicaid and Medicare Services (CMS) require hospitals to
notify you of these rights.
Advance beneficiary notice of non-payment (ABN)
Medicare only covers services it considers reasonable and medically
necessary for someone with your diagnosis. Your doctor's office does
not always know in advance what services Medicare will cover.
The Advance Beneficiary Notice of Non-Payment (ABN) form notifies
you Medicare may not pay for certain services. It will list any tests
that may (or may not) be covered. It will also inform you of your
responsibility to pay for services if Medicare denies payment.
Signing an ABN will not affect Medicare's decision to pay for a test.
Options when an ABN is required
In some cases, you must sign an ABN before services are performed.
In this case, you have two options:
- Sign the ABN, agree to pay for the service if Medicare will
not, and receive the service
- Refuse financial
responsibility if Medicare will not pay for the service, and do not
receive the service
Signing the ABN simply indicates that you were informed of your
responsibility to pay for services if Medicare refuses. Refusing to
sign it does not change your options.
If you refuse to sign the ABN but accept the service, a witness will
sign it, noting that you refused. If Medicare does not pay for the
service, you will be billed.
What to do if you have questions
Your doctor's office can provide information about what is likely to
be covered by Medicare.
Your doctor can help you make informed decisions about the necessity
of tests and procedures, as well as alternatives.