RE: Re: Medicare non coverage and part D

[Guest guest]

FYI

unique situation : Medicare and BC coverage

Pt has bone marrow transplant which is not covered under medicare guideline's,

her secondary insurance BC--covers the transplant.

Now pt is age 65 and has medicare and a part D rx plan, the rx plan is denying

coverage for immuno's because they should be covered under pts medicare part

B--however these are from a non approved bone marrow transplant.---any

suggestions on how to resolve this with the part D rx carrier???

Any suggestions would be appreciated.

Thanks

Allegheny General Hospital

mmartin1@...

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[Guest guest]

Hi ,

I get this all the time. Contact the insurance carrier and they should have a PA form specific to this which asks if the pt had a Medicare covered transplant, and just answer no. You may have to call them to reiterate it. Sometimes they can do it on the pharmacy level. Good luck.

Hogan Transplant Financial Coordinator Lahey Clinic 41 Mall Rd. Burlington, MA 01805 phone fax

RE: Re: Medicare non coverage and part DFYIunique situation : Medicare and BC coveragePt has bone marrow transplant which is not covered under medicare guideline's, her secondary insurance BC--covers the transplant.Now pt is age 65 and has medicare and a part D rx plan, the rx plan is denying coverage for immuno's because they should be covered under pts medicare part B--however these are from a non approved bone marrow transplant.---any suggestions on how to resolve this with the part D rx carrier???Any suggestions would be appreciated.Thanks Allegheny General Hospitalmmartin1@...**********************************************************************This email and any files transmitted with it are confidential andintended solely for the use of the individual or entity to whom theyare addressed. If you have received this email in error please notifythe West Penn Allegheny Health System Help Desk at 412 330-4357.This footnote also confirms that this email message has been swept byMIMEsweeper for the presence of computer viruses.**********************************************************************See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.