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Updates to:
Guiding Those Left Behind in Missouri
CHAPTER 1:
VA Pamphlet 051-000-00228-8 FEDERAL
BENEFITS FOR VETERANS AND DEPENDENTS
now costs $7, however you can download it without charge: http://www.va.gov.
CHAPTER 1: The
telephone number for the Arlington National Cemetery is (703) 607-8585.
Chapter
2: The number for information about COBRA has been changed to (866)
444-3272
CHAPTER 3: The Web site for the FAA is
http://www.faa.gov.
The telephone number to call is (866) 835-5322.
Page 42 MISSOURI DEPT. OF INSURANCE
The telephone number for the Missouri Department of Insurance is
(573) 751-4126.
Page 150 COMPENSATION FOR PERSONAL REPRESENTATIVE
The printed schedule for compensation for the Personal Representative
has a missing line. The correct schedule as per Missouri statue
473.153 is:
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5% of the first $5,000
4% of the first $20,000
3% of the first $75,000
2 3/4% of the first $300,000
2 1/1% of the first $600,000
2% of the first $1,000,000.
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CHAPTER
4 2004 MEDICARE UP-DATE
There are many new changes in the Medicare system.
MEDICAL BILLS COVERED BY INSURANCE
If the decedent had health
insurance you may receive an invoice stamped "THIS
IS NOT A BILL." This means
the health care provider has submitted the bill to the
decedent’s health insurance company and expects to be paid by
them. If the decedent was receiving Medicare, you will receive a
Medicare Summary Notice
listing all of the services or supplies that were billed to
Medicare for the prior 30 days. In some areas of the country,
you can get a copy of the decedent’s Medicare Summary Notice
from the Internet: http://www.medicare.gov
HOW TO CHECK MEDICARE BILLING
The structure of Medicare has
been changed giving people in some parts of the country, the
option of staying with the Original
Medicare Plan or
choosing one of the Medicare +
Choice Plans. Coverage
differs depending on which plan is chosen. If the decedent was
covered by Medicare, you need to determine whether he was
covered under the Original Medicare Plan, or whether he chose a
Medicare + Choice Plan. The publication Medicare
and You explains coverage
under the different options. See Chapter 2 to obtain a copy of
the booklet.
An important billing question is whether the health care
provider agreed to accept Medicare assignment,
meaning that they agreed to accept the Medicare-approved amount.
If so, the patient is responsible for the coinsurance (usually
20% of the approved amount) and any deductible amount. Doctors
and health care providers who do not accept assignment, are
limited in the amount they can charge for a Medicare covered
service. The highest they can charge is 15% over the
Medicare-approved amount. This Limiting
Charge applies only to
certain services and does not apply to supplies and equipment.
If all of this appears confusing, it is.
To check the decedent’s Medicare billing,
you first need to determine whether he was in the Original
Medicare Plan or in one of the Medicare + Choice Plans. The
Medicare and You booklet explains what is covered
under the Original Medicare Plan. You will need a copy of the
contract for the Medicare + Choice Plans to determine what is
covered under that plan. If
the decedent was in the Original Medicare Plan, you need to
determine whether the health care provider accepted assignment;
and if not whether the Limiting Charge applies to the services
provided. Finally if assignment is accepted or the Limiting
Charge applies, you need to determine the Medicare-approved
amount.
NOTE: A doctor or supplier can give the
patient an Advance Beneficiary Notice
that says Medicare probably will not pay for a service.
If the decedent received such notice and signed an agreement
saying he wants the service and agrees to pay for it, then if he
received the service, his estate is now liable to pay that debt.
COST OF NURSING CARE IN ORIGINAL MEDICARE
PLAN
Medicare pays for the first 20 days of nursing care.
For days 21 to 100, the patient pays up to $105/day.
Medicare does not pay for nursing care beyond 100 days.
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