Tuesday 7 October 2014

Medicare supplement coverage plan responsibilities - Medicare select

 What Is Medicare Select?
Medicare Select is a Medicare Supplement product available only to AARP® members who reside within the service area of a hospital which participates in our Medicare Select network. It is a lower cost alternative to Standardized

Medicare Supplement coverage.
Responsibilities of Medicare Select members

To offer the plan at a lower premium, we require that Medicare Select members utilize a participating hospital for all inpatient and outpatient hospital services (except emergency care and services provided when members are outside of their service area).

Hospital responsibilities

Participating hospitals agree to a reduced/waived reimbursement of Medicare’s Part A In-Hospital deductible. Cost savings associated with hospitals’ reduction/waiver of Medicare’s Part A In-Hospital deductible are passed on to Medicare Select members in the form of lower premium cost.

To submit a Medicare Part A or Part B Intermediary claim for a Medicare Select insured, mail a copy of the standard

CMS billing form along with a Medicare Explanation of Benefits or Medicare Remittance Advice to:
AARP® Medicare Select
UnitedHealthcare Claim Division
P.O. Box 740819
Atlanta, GA 30374-0819


Note: Medicare Part B claims billed to a Medicare carrier are, in most cases, received electronically from the Medicare carrier.

To promote timely processing on all claim submissions, follow standardized Medicare billing practices. Be sure to include the 11-digit AARP® Medicare Select member’s health care ID number on the standard CMS billing form.

What does Medicare Select cover in addition to Part A In-Hospital deductible?

• In-Hospital Part A coinsurance for days 61 through 90 in a Medicare Benefit Period.
• In-Hospital Part A coinsurance for days in which Lifetime Reserve days are used.
• Medicare Part A eligible expenses for a Lifetime Maximum of 365 days after all Medicare Part A benefits are exhausted.
• Medicare Part B coinsurance (generally 20% of Medicare’s approved amount).
• Medicare Part B deductible amount applied each calendar year.
• Skilled Nursing Facility stays - the daily coinsurance amount for days 21 to 100 for stays eligible under Medicare.
• Medicare Parts A and B Blood deductible: Charge incurred for the first three pints of unreplaced blood furnished in a calendar year.
• Foreign Travel Emergency.

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