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Hey there everyone!

I have a question for you all:

I have a patient that has Medicare primary now and United Health Care secondary.

We are out of network for UHC and they are not willing to do a contract with us

for anything because the plan is secondary. I was told today by a representative

from UHC that because Medicare would pay more on all services covering 80%,UHC

will not cover more of the expense because they would only cover 60% on their

own.

I have two questions:

1. If this is true- do the deductibles and out of pocket maximums come into play

for UHC? Their out of network out of pocket max is $2500 so I'm wondering if

Medicare covers 80% then the patient is responsible for 20% up to $2500? Or is

that now how this works?

2. If the first question isn't true, could a patient in this position benefit

from a supplemental plan?

I really appreciate your help on this! We have had the patient on our list for

years and want to help him the best way I can.

Thank you!!

Jodi MacFarland-

Financial Coordinator

Saint 's Kidney Transplant

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