Medicare won’t pay for preventative examination

Written by Chronicle Staff. Posted in Community News & People in the News, Senior Living

Published on November 07, 2018 with No Comments

On Oct. 29, 2018, I received a letter from a medical service provider which explained that Medicare would not pay for a certain medical service to a woman who is one of our senior citizen clients.  The firm is based in Porter County.

In the letter from the group of doctors, the billing manager wrote, “Medicare now will only pay for wellness visits. Our office follows ACOG guidelines on performing a preventative visit for all our patients – not a ‘wellness’ visit.”

The medical service knew of the key difference and did their best to explain the difference to our client.  The firm even had our client sign an Advance Beneficiary Notice (ABN) which explained that there was a high probability that Medicare would not approve or cover the preventative examination of our client.  The ABN form let the patient know that she, and not Medicare, probably would have to pay the bill.

Why the distinction?  Why the extra charge to a senior citizen woman who wants to visit a doctor to prevent disease?  Why doesn’t Medicare approve and cover this preventative medical service for a senior citizen?

The Obamacare law cut over $716 billion from the Medicare budget.  I did not imagine that figure.  The figure comes from a two-year study of the Obamacare law that was published by the Congressional Budget Office in July 2012.  Since the passing of the Obamacare law and that drastic reduction in the Medicare budget, the federal government has been re-writing Medicare rules to save the federal government money and push more health care costs onto senior citizens.

But, also, the Congressional Budget Office revealed that the Obamacare law cut $56 billion that would have gone to hospitals that regularly serve poor people and $114 billion from the budget for Medicaid and CHIP services.  So, the Obamacare law cut billions of dollars from Medicare and programs that help poor people with medical expenses.  These facts surprise most people who supported Obamacare.  But, these facts reveal that the Obamacare law was not well written if you care about seniors and the poor.

All opinions, conclusions or recommendations expressed are solely those of the author and do not necessarily reflect the views of The Chronicle.  Woodrow Wilcox is the senior medical bill case worker at Senior Care Insurance Services in Merrillville, Indiana.  He has helped clients of that insurance agency to save over one million dollars by finding and correcting medical bill errors that were caused by mistakes in the Medicare system.   For other articles by Wilcox, visit www.americanclarion.com.


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