What is the name of your state? Florida
(Admin: If you can recommend another forum where this question should be posted, please advise)
I am a current resident of Florida, former resident of California.
I have a Medigap Insurance Policy - Level F, still with a California insurer (working to switch to Florida insurer). Among other things, Level F is supposed to pay for the annual Part B deductible.
Can my Medigap insurer refuse to honor the waiver of the Part B annual deductible if I use out of state doctors?
My insurer said that although I have the Level F policy, they will only honor the waiver of the Part B deductible if I have used doctors in the state of California who have directly contracted with them. In other words, I submitted my first claim of the year for around $150 - a doctor's visit, not an "in-hospital" claim. The claim was processed as follows: $5 was disallowed, $25 was paid, and $120 was "applied to my deductible". Therefore, I will be responsible for paying the $120. When I questioned the insurer, "What deductible?? Level F covers my annual Part B deductible", my insurer replied, "no, we would have paid the $120 only if you had used a California doctor who has directly contracted with us."
Shouldn't the Part B deductible be covered no matter where my medical service occurs? BTW, my plan is not an HMO, I can choose whatever doctor I like ...What is the name of your state?
(Admin: If you can recommend another forum where this question should be posted, please advise)
I am a current resident of Florida, former resident of California.
I have a Medigap Insurance Policy - Level F, still with a California insurer (working to switch to Florida insurer). Among other things, Level F is supposed to pay for the annual Part B deductible.
Can my Medigap insurer refuse to honor the waiver of the Part B annual deductible if I use out of state doctors?
My insurer said that although I have the Level F policy, they will only honor the waiver of the Part B deductible if I have used doctors in the state of California who have directly contracted with them. In other words, I submitted my first claim of the year for around $150 - a doctor's visit, not an "in-hospital" claim. The claim was processed as follows: $5 was disallowed, $25 was paid, and $120 was "applied to my deductible". Therefore, I will be responsible for paying the $120. When I questioned the insurer, "What deductible?? Level F covers my annual Part B deductible", my insurer replied, "no, we would have paid the $120 only if you had used a California doctor who has directly contracted with us."
Shouldn't the Part B deductible be covered no matter where my medical service occurs? BTW, my plan is not an HMO, I can choose whatever doctor I like ...What is the name of your state?
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