Show:
Medicare Basics
Medigap Rules
Medigap Policies
Misc
Eligibility
100
Who runs Medicare?
What is the Federal Government
100
What are the Medigap policies that BCBSNE currently offers?
What are Plans A, B, C, F, G, & L
100
Does the Plan F cover the ‘Limiting’ charge over the Medicare approved amount?
Yes it does
100
What Skilled Nursing Facility days are paid at 100% by Medicare?
What is 1-20 days
100
When is the initial open enrollment period for Medicare Part B coverage?
What is the 3 months prior to the member's 65th birthday. the month of their birthday and the 3 months following their birthday for a total of 7 months.
200
What services are covered under Medicare Part A?
What is the part of Medicare which covers Inpatient Care in Hospitals, Skilled Nursing Facilities, Hospice and Home Health care
200

What is the Medicare Part A deductible for 2020 for the 1-60 day?

What is $1408

200
Does the Plan A cover the Medicare Part A deductible for the 1-60 day of the benefit period?
No, it does not
200
Do Medicare Supplemental members have waiting periods for pre-existing conditions?
There are never any waiting periods on Medicare Supplemental plans.
200
Can a member keep their coverage if they move to Florida?
What is Yes? They can keep their coverage but they will not be able to make any changes to the coverage.
300
What services are covered under Medicare Part B?
What is the part of Medicare which covers doctor services, outpatient hospital care, home health care, ambulance and medical supplies
300

What is the Medicare Part B deductible for 2020?

What is $198

300
Does the Plan B cover the Skilled Nursing Facility for the 21-100 day?
No, it does not
300

Where in HealthRules can you find the Medicare HIB/ID number.

What is in the Medicare tab.

300
Who do I call if I have not received my application to apply for medicare? And what is the phone number?
What is the social security administration (SSA) at 800-772-1213.
400
When would you refer the Provider to the Medicare Helpline 800-633-4227?
To answers specific questions about what Medicare A & B covers
400
Define the Medicare Benefit Period?
What is a “benefit period” begins the day you go to a hospital or skilled nursing facility (SNF). The benefit period ends when you haven’t received any hospital care (or skilled care in a SNF) for 60 days in a row.
400
The provider wants to confirm that BCBSNE will cover a heart transplant for a Plan F member.
We will advise the provider we will use Medicare guidelines and if Medicare will approve, we will pay the Medicare deductible and coinsurance amounts.
400
The number of days the provider must wait to file a claim to us IF the member is set up on the Medicare cross-over.
What is 30 days
400
Does Midwest Respiratory Care Inc., in Lincoln NE accept assignment for a Medicare supplement member?
What is they accept Medicare but they do not accept Medicare assignment so the member may be responsible for the additional limiting charge if the supplement does not cover it.
500
What is the limiting charge?
The provider who does not accept assignment can charge the member 15% above the Medicare approved amount.
500

What are the advantages to seeing a physician who accepts Medicare assignment?

What is the provider will write off any amount over the Medicare approved amount.

500
How can I tell if the plan will cover the $5.00 copay for outpatient prescription drugs while in a hospice.
What is the 06/10 contract revision date listed in the Benefit Matrix title
500

How can you identify a Medicare cross-over is active?

What is in the General tab in healthrules, under additional ID numbers.   There is a Y showing that yes the crossover is active

500
Where can I look to see how long this member has actually been with BCBS of NE
Coverage Inquiry> ELIG tab