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Health Insurance and Medicare question--weird?


Our mom just died at age 64 from numerous complications from a stroke. The last week and a half of her life the doctor thought dialysis may help her kidneys but it did not. She had never had any serious problems with her kidneys until about the last 3 wkks of her life--her entire body was failing her. Anyway she had 'great insurance" that even covers dialysis ect.. In fact it covers most everything at 100%. However they said that since she had "renal failure" her primary insurance should be Medicare. She was not even 65 and to top it off she died less than 2 wks after serious "renal failure" was considered a problem. MY point is that even if she had been able there would not have been time to even apply for Medicare because SHE DIED. How can they rationalize that Medicare should be her primary insurance to cover renal failure costs??????? Renal failure was one of MANY compounded listed reasons for her death. She died of an entire breakdown of her system.

http://www.todaysmedicare.com

First of all let me say sorry for your loss. I would need more information to give you an exact answer but generally IF a person is Medicare eligible and HAS Medicare then it is the primary payer. If someone has "credible coverage" and not Medicare eligible then obviously the insurance company is responsible as long as the condition was not pre-existing prior to obtaining coverage. If for some reason she HAD Medicare that you were not aware of that may be why the insurance company has made that claim. But the general rule of thumb for those ENROLLED in Medicare is----Medicare pays first and the insurance picks up second.

You can still apply on her behalf. Renal failure would have qualified her for Medicare. It's supposed to be a perk of Medicare.

I would need more information to comment further. However, I'm sorry for your loss.

I do not understand the insurance company. The insurance company is the first to pay, and then the secondary is Medicare/Medicaid.

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