I'm interested in the experiences (good and bad) from those that have an FEHB plan that wraps medicare and if you've ever had any issues where medicare had paid their 80% but FEHB denied their 20$ and left you with the bill.
Supplements (Plan G etc) must pay if medicare pays, but, FEHB is not a supplement that must pay. As secondary insurance they will pay only if all the t's are crossed and i's are dotted. (Prior Authorizations etc)
Has this been an issue for you? If not, do you think it's possible that when FEHB wraps medicare, they may ease the prior authorization requirement since they are only paying the 20% anyway and they don't want to lose you as a customer as they are still getting the bigger premium to cover a much smaller share?
Supplements (Plan G etc) must pay if medicare pays, but, FEHB is not a supplement that must pay. As secondary insurance they will pay only if all the t's are crossed and i's are dotted. (Prior Authorizations etc)
Has this been an issue for you? If not, do you think it's possible that when FEHB wraps medicare, they may ease the prior authorization requirement since they are only paying the 20% anyway and they don't want to lose you as a customer as they are still getting the bigger premium to cover a much smaller share?
Statistics: Posted by ljd46506 — Fri Apr 26, 2024 3:40 pm — Replies 6 — Views 269
