RE: Kidney Recipients with Living Donors

[Guest guest]

The problem I see is with Part A. If he doesnt enroll they will not cover the

immunos in the future when he turns 65. and part A is FREE. I have had one

patient that opted in on Part B right after transplant and then discontinued it

within a couple of months B did pay for her donor, but the patient now has large

amounts due .

We dont require them to have medicare but it is highly recommended.

Whitney Folsom, TFC

ETMC Transplant Program

1100 E Lake St ste 340

Tyler, TX 75701

phone

fax

wlfolsom@...

>>> lmk276 6/13/2012 9:36 AM >>>

Good morning all,

I have a patient who has an individual BCBS plan who is on dialysis and eligible

for Medicare, but has opted not to enroll in either A or B at this time. He

stated that he is working and his premiums are affordable and didn't see the

need for Medicare. He stated that he would probably not even get it post

transplant. He has multiple living donors being worked up currently. My question

is- does he have to enroll in Medicare B? Do any centers require patients with

living donors enroll in Medicare B before transplant? What is the potential

disadvantage of not enrolling so that I can explain to him correctly?

Thanks!!

Leah

CMC

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[Guest guest]

The problem I see is with Part A. If he doesnt enroll they will not cover the

immunos in the future when he turns 65. and part A is FREE. I have had one

patient that opted in on Part B right after transplant and then discontinued it

within a couple of months B did pay for her donor, but the patient now has large

amounts due .

We dont require them to have medicare but it is highly recommended.

Whitney Folsom, TFC

ETMC Transplant Program

1100 E Lake St ste 340

Tyler, TX 75701

phone

fax

wlfolsom@...

>>> lmk276 6/13/2012 9:36 AM >>>

Good morning all,

I have a patient who has an individual BCBS plan who is on dialysis and eligible

for Medicare, but has opted not to enroll in either A or B at this time. He

stated that he is working and his premiums are affordable and didn't see the

need for Medicare. He stated that he would probably not even get it post

transplant. He has multiple living donors being worked up currently. My question

is- does he have to enroll in Medicare B? Do any centers require patients with

living donors enroll in Medicare B before transplant? What is the potential

disadvantage of not enrolling so that I can explain to him correctly?

Thanks!!

Leah

CMC

===========================================================

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[Guest guest]

Can we still put the donor costs on the cost report if the recip hasn't enrolled in B? Sent via BlackBerry by AT&TSender: TxFinancialCoordinators Date: Wed, 13 Jun 2012 09:52:41 -0500To: <TxFinancialCoordinators >ReplyTo: TxFinancialCoordinators Subject: Re: Kidney Recipients with LivingDonors The problem I see is with Part A. If he doesnt enroll they will not cover the immunos in the future when he turns 65. and part A is FREE. I have had one patient that opted in on Part B right after transplant and then discontinued it within a couple of months B did pay for her donor, but the patient now has large amounts due .We dont require them to have medicare but it is highly recommended.Whitney Folsom, TFCETMC Transplant Program1100 E Lake St ste 340Tyler, TX 75701 phone faxwlfolsom@...>>> lmk276 6/13/2012 9:36 AM >>>Good morning all, I have a patient who has an individual BCBS plan who is on dialysis and eligible for Medicare, but has opted not to enroll in either A or B at this time. He stated that he is working and his premiums are affordable and didn't see the need for Medicare. He stated that he would probably not even get it post transplant. He has multiple living donors being worked up currently. My question is- does he have to enroll in Medicare B? Do any centers require patients with living donors enroll in Medicare B before transplant? What is the potential disadvantage of not enrolling so that I can explain to him correctly?Thanks!!Leah CMC===========================================================This message is confidential, intended onlyfor the named recipient(s) and may containinformation that is privileged or exempt fromdisclosure under applicable law. If you arenot the intended recipient(s), you are notifiedthat the dissemination, distribution or copyingof this message is strictly prohibited. If youreceived this message in error, or are not thenamed recipient(s), please notify the senderand delete this e-mail from your computer.ETMC has implemented secure messaging forcertain types of messages. For more informationabout our secure messaging system, go to: http://www.etmc.org/mail/Thank you.===========================================================

[Guest guest]

Can we still put the donor costs on the cost report if the recip hasn't enrolled in B? Sent via BlackBerry by AT&TSender: TxFinancialCoordinators Date: Wed, 13 Jun 2012 09:52:41 -0500To: <TxFinancialCoordinators >ReplyTo: TxFinancialCoordinators Subject: Re: Kidney Recipients with LivingDonors The problem I see is with Part A. If he doesnt enroll they will not cover the immunos in the future when he turns 65. and part A is FREE. I have had one patient that opted in on Part B right after transplant and then discontinued it within a couple of months B did pay for her donor, but the patient now has large amounts due .We dont require them to have medicare but it is highly recommended.Whitney Folsom, TFCETMC Transplant Program1100 E Lake St ste 340Tyler, TX 75701 phone faxwlfolsom@...>>> lmk276 6/13/2012 9:36 AM >>>Good morning all, I have a patient who has an individual BCBS plan who is on dialysis and eligible for Medicare, but has opted not to enroll in either A or B at this time. He stated that he is working and his premiums are affordable and didn't see the need for Medicare. He stated that he would probably not even get it post transplant. He has multiple living donors being worked up currently. My question is- does he have to enroll in Medicare B? Do any centers require patients with living donors enroll in Medicare B before transplant? What is the potential disadvantage of not enrolling so that I can explain to him correctly?Thanks!!Leah CMC===========================================================This message is confidential, intended onlyfor the named recipient(s) and may containinformation that is privileged or exempt fromdisclosure under applicable law. If you arenot the intended recipient(s), you are notifiedthat the dissemination, distribution or copyingof this message is strictly prohibited. If youreceived this message in error, or are not thenamed recipient(s), please notify the senderand delete this e-mail from your computer.ETMC has implemented secure messaging forcertain types of messages. For more informationabout our secure messaging system, go to: http://www.etmc.org/mail/Thank you.===========================================================

[Guest guest]

Yes, because the recipient/candidate is entitled to Medicare.

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of lmk_276@...

Sent: Wednesday, June 13, 2012 10:59 AM

To: TxFinancialCoordinators

Subject: Re: Kidney Recipients with Living Donors

Can we still put the donor costs on the cost report if the recip hasn't enrolled in B?

Sent via BlackBerry by AT & T

Sender: TxFinancialCoordinators

Date: Wed, 13 Jun 2012 09:52:41 -0500

To: <TxFinancialCoordinators >

ReplyTo: TxFinancialCoordinators

Subject: Re: Kidney Recipients with Living Donors

The problem I see is with Part A. If he doesnt enroll they will not cover the immunos in the future when he turns 65. and part A is FREE. I have had one patient that opted in on Part B right after transplant and then discontinued

it within a couple of months B did pay for her donor, but the patient now has large amounts due .

We dont require them to have medicare but it is highly recommended.

Whitney Folsom, TFC

ETMC Transplant Program

1100 E Lake St ste 340

Tyler, TX 75701

phone

fax

wlfolsom@...

>>> lmk276 6/13/2012 9:36 AM >>>

Good morning all,

I have a patient who has an individual BCBS plan who is on dialysis and eligible for Medicare, but has opted not to enroll in either A or B at this time. He stated that he is working and his premiums are affordable and didn't see the need for Medicare. He stated

that he would probably not even get it post transplant. He has multiple living donors being worked up currently. My question is- does he have to enroll in Medicare B? Do any centers require patients with living donors enroll in Medicare B before transplant?

What is the potential disadvantage of not enrolling so that I can explain to him correctly?

Thanks!!

Leah

CMC

===========================================================

This message is confidential, intended only

for the named recipient(s) and may contain

information that is privileged or exempt from

disclosure under applicable law. If you are

not the intended recipient(s), you are notified

that the dissemination, distribution or copying

of this message is strictly prohibited. If you

received this message in error, or are not the

named recipient(s), please notify the sender

and delete this e-mail from your computer.

ETMC has implemented secure messaging for

certain types of messages. For more information

about our secure messaging system, go to:

http://www.etmc.org/mail/

Thank you.

===========================================================

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected from disclosure under applicable law. If you are not the intended recipient, your use of this message for

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[Guest guest]

Yes, because the recipient/candidate is entitled to Medicare.

Deidra M. Simano

Transplant Operations Analyst

Department of Transplant Surgery

Dartmouth-Hitchcock Lebanon

Phone: (603) 653.3689 / Fax: (603) 676.4287

Transplant Secretary (603) 653.3931

Dartmouth-Hitchcock.org

From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ]

On Behalf Of lmk_276@...

Sent: Wednesday, June 13, 2012 10:59 AM

To: TxFinancialCoordinators

Subject: Re: Kidney Recipients with Living Donors

Can we still put the donor costs on the cost report if the recip hasn't enrolled in B?

Sent via BlackBerry by AT & T

Sender: TxFinancialCoordinators

Date: Wed, 13 Jun 2012 09:52:41 -0500

To: <TxFinancialCoordinators >

ReplyTo: TxFinancialCoordinators

Subject: Re: Kidney Recipients with Living Donors

The problem I see is with Part A. If he doesnt enroll they will not cover the immunos in the future when he turns 65. and part A is FREE. I have had one patient that opted in on Part B right after transplant and then discontinued

it within a couple of months B did pay for her donor, but the patient now has large amounts due .

We dont require them to have medicare but it is highly recommended.

Whitney Folsom, TFC

ETMC Transplant Program

1100 E Lake St ste 340

Tyler, TX 75701

phone

fax

wlfolsom@...

>>> lmk276 6/13/2012 9:36 AM >>>

Good morning all,

I have a patient who has an individual BCBS plan who is on dialysis and eligible for Medicare, but has opted not to enroll in either A or B at this time. He stated that he is working and his premiums are affordable and didn't see the need for Medicare. He stated

that he would probably not even get it post transplant. He has multiple living donors being worked up currently. My question is- does he have to enroll in Medicare B? Do any centers require patients with living donors enroll in Medicare B before transplant?

What is the potential disadvantage of not enrolling so that I can explain to him correctly?

Thanks!!

Leah

CMC

===========================================================

This message is confidential, intended only

for the named recipient(s) and may contain

information that is privileged or exempt from

disclosure under applicable law. If you are

not the intended recipient(s), you are notified

that the dissemination, distribution or copying

of this message is strictly prohibited. If you

received this message in error, or are not the

named recipient(s), please notify the sender

and delete this e-mail from your computer.

ETMC has implemented secure messaging for

certain types of messages. For more information

about our secure messaging system, go to:

http://www.etmc.org/mail/

Thank you.

===========================================================

IMPORTANT NOTICE REGARDING THIS ELECTRONIC MESSAGE:

This message is intended for the use of the person to whom it is addressed and may contain information that is privileged, confidential, and protected 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.

[Guest guest]

A couple of things come to mind. He should be certain his individual policy does not “require” him to enroll in Medicare by virtue of that little clause that states if member is eligible for Medicare, the plan will begin to act as a secondary payer on the day Medicare should be prime. Since it’s an individual policy, that means they’ve given themselves this permission from the first possible day of entitlement. That’s not the case for every individual policy so the research should be done. Apart from that we do “strongly encourage” – effectively we insist – on enrollment in A and B when there is a living donor involved. For one, there is rarely full coverage for donor costs on private plans. More importantly from my perspective, Medicare offers more reliable protection if a donor complication arises. on Transplant Financial Coordinator Legacy Good Samaritan Hospital Legacy Transplant Services 1040 NW 22nd Ave Ste 480 Portland OR 97210 direct main office toll-free fax lmorriso@... From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of lmk276Sent: Wednesday, June 13, 2012 7:37 AMTo: TxFinancialCoordinators Subject: Kidney Recipients with Living Donors Good morning all, I have a patient who has an individual BCBS plan who is on dialysis and eligible for Medicare, but has opted not to enroll in either A or B at this time. He stated that he is working and his premiums are affordable and didn't see the need for Medicare. He stated that he would probably not even get it post transplant. He has multiple living donors being worked up currently. My question is- does he have to enroll in Medicare B? Do any centers require patients with living donors enroll in Medicare B before transplant? What is the potential disadvantage of not enrolling so that I can explain to him correctly?Thanks!!Leah CMC

[Guest guest]

Not for sure if you have received an answer to this. The patient really needs to read his BCBS contract. Our individual Anthem policy in KY states if pt is eligible for Medicare and chooses not to pick it up, Anthem will pay as if he has Medicare., paying only the inpatient deductible amount and 20% of physician charges. Be very careful as this has happened to patients in our area.

Fern Milam, Financial Coordinator Transplant and Ventricular Assist Device Jewish Hospital & St.'s Healthcare 200 Abraham Flexner WayLouisville, KY 40202502--587-4985 (fax)

To: TxFinancialCoordinators Sent: Wednesday, June 13, 2012 10:36 AMSubject: Kidney Recipients with Living Donors

Good morning all, I have a patient who has an individual BCBS plan who is on dialysis and eligible for Medicare, but has opted not to enroll in either A or B at this time. He stated that he is working and his premiums are affordable and didn't see the need for Medicare. He stated that he would probably not even get it post transplant. He has multiple living donors being worked up currently. My question is- does he have to enroll in Medicare B? Do any centers require patients with living donors enroll in Medicare B before transplant? What is the potential disadvantage of not enrolling so that I can explain to him correctly?Thanks!!Leah CMC

[Guest guest]

All transplant patients with insurance who don’t want to apply for Medicare needs to be aware of this importance information.  Thanks Fern for reminding us.    From: TxFinancialCoordinators [mailto:TxFinancialCoordinators ] On Behalf Of Fern MilamSent: Thursday, June 14, 2012 9:24 AMTo: TxFinancialCoordinators Subject: Re: Kidney Recipients with Living Donors Not for sure if you have received an answer to this. The patient really needs to read his BCBS contract. Our individual Anthem policy in KY states if pt is eligible for Medicare and chooses not to pick it up, Anthem will pay as if he has Medicare., paying only the inpatient deductible amount and 20% of physician charges. Be very careful as this has happened to patients in our area. Fern Milam, Financial Coordinator Transplant and Ventricular Assist Device Jewish Hospital & St.'s Healthcare 200 Abraham Flexner WayLouisville, KY 40202502--587-4985 (fax)To: TxFinancialCoordinators Sent: Wednesday, June 13, 2012 10:36 AMSubject: Kidney Recipients with Living Donors Good morning all, I have a patient who has an individual BCBS plan who is on dialysis and eligible for Medicare, but has opted not to enroll in either A or B at this time. He stated that he is working and his premiums are affordable and didn't see the need for Medicare. He stated that he would probably not even get it post transplant. He has multiple living donors being worked up currently. My question is- does he have to enroll in Medicare B? Do any centers require patients with living donors enroll in Medicare B before transplant? What is the potential disadvantage of not enrolling so that I can explain to him correctly?Thanks!!Leah CMC