Medicare Part B while working and really high employer plan deductible? who pays?

[jc]

My mom turned 64 last year and was eligible for Medicare. She
continues to work for a really small employer.

In prior years she paid around $350/mo for insurance just for herself
every month through her employer. I don't know the details of her plan
but in prior years had used medical benefits and even Hosiptial and
only paid a small co-pay.

Recently, and possibly ill advised, she opted to use her employer's
United medical plan as Part-B. She did not know this, but the plan
changed and she has a really high deductable .. like $4000 now.

She had a colonoscopy and is now getting a bill for around $3500.
United is saying it falls under her deductable, and Medicare is saying
her employer coverage must come first... Say what??? Does this make
any sense, what's the point of Part-B if coverage would be better
without it?

Another stupid thing is that the company owner who is also covered has
no deductible.

Medicare says if her employer has less than 20 covered they will cover
the deductible or first.. and while it appears her employer has only 9
covered, many of the employers ownership and family might be covered
as well.

Does this make any sense?

[Avrum Lapin]

In article
<2a78ccf2-b429-4de8...@j24g2000yqa.googlegroups.com>,
jc <jo...@webdos.com> wrote:

I see problems here.

If your mother is under 65 why would medicare be involved?

How can she have a part B if she is not in Medicare.

Was your mother offered a no deductible plan.

The $3500 for a colonoscopy is way too much. The medicare approved
payment for my combined colonoscopy and endoscope was $1100. The
hospital took the biggest haircut bulling $3045 and getting only $642
for use of the day surgery facilities. Room for negotiation.

I suggest that if Medicare is really involved that your mom (perhaps
with you accompaning her) seek no cost help from a SHIP counsellor (call
1-800-MEDICARE) for the toll free number in her state.