Question:
Medicare is my primary, BCBS is backup.

Dr office said they don't need ok from Medicare but do from BCBS of ILLINOIS. I thought the secondary insurance covered anything that Medicare pays?    — Donna T. (posted on November 29, 2002)


November 29, 2002
you would think that wouldn't you!!! But nope, it can't be that easy!! Godo luck to you, hope that you get the approval with out any speed bumps!!
   — Vicki L.

November 29, 2002
Unfortunately, it does not work that way. I am really not sure if Medicare will pay for the surgery, but you still have to make sure that BCBS will cover it, even if Medicare does or doesn't. Most plans, regardless of who the carrier is, still have to follow the stipulations of the policy. If there is a clause in your policy that states they will not cover any treatment for weight loss including surgical treatment, then BCBS is not going to pay, regardless of Medicare's coverage. I work for an insurance company, so if you have any other questions, feel free to email me. Good Luck!!
   — Adrienne S.

November 29, 2002
I was told by the doctor that medicare will pay for my surgery if it is considered a necessity. I called my Insurance co which is Standard Life and was told it would pay 100 percent of what medicare does not. I hope they follow through.
   — Carol H.

November 29, 2002
I have Medicare and Mutual of Omaha. Mof O has a tight exclusion policy. Medicare paid as the primary in my medically necassay situation. M of O paid some of the hospital expenses and tests. I ended up paying $48 out of pocket, less than I ever dreamed!
   — Linda M.

November 29, 2002
Check with your secondary carrier. If a service is denied by Medicare as non-covered, most secondary carriers will deny as well.
   — Kim DeHart




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