I got my first bill from my medical adventure the other day: $1,083.74 for office visits and lab tests at the clinic I went to on the day I discovered I was sick. Medicare had declined to pay any of it.
It was a mistake fairly easily corrected. Medicare had me listed as having "other insurance" as the primary payer. It seems that Medicare updates its records once a year, in October. So unless you make a point of telling them what's going on, if you change insurers after their update day, they won't know about it until next October. In my case, I had paid-up insurance from my former employer through the end of October 2007 -- after the Medicare update. At the end of October, that policy ceased, and Medicare became my primary carrier. (I also have a Medicare supplemental policy.) But Medicare didn't know about it, so all of my medical bills from October 2007 to October 2008 were denied.
This good news out of all this medical mishegoss is that it was relatively easily cleared up. Conservatives are always arguing against government programs because of the "bureaucracy." But my experience with Medicare is that their bureaucracy is more efficient and responsive and more pleasant to deal with than that of the big private insurance companies. Maybe it's because the big private insurance companies can pick and choose whom they insure, while Medicare has to deal with anyone over 65, some of whom must require careful and clear explanations. As I know from my experience in the nursing home, anyone who works with the elderly needs the patience of a saint.
This is, of course, another argument for a single-payer national insurance system -- the only kind of health reform that I think will work. It took me three phone calls to clear it all up -- one to the clinic to find out why the charges weren't paid, one to Medicare to ask why they weren't listed as the primary insurer and to be assured that the mistake was corrected, and another to the clinic to ask them to resubmit. One phone call should have been sufficient.
And don't get me started on voice-recognition phone trees:
ROBOVOICE: You said "enrollment."
ME: No, I didn't! I said "claims."
ROBOVOICE: Please choose from one of the following options....