Wiki Medicare advantage and medicaid

[Akulo]

When a patient has a medicare advantage plan, does medicaid always pay for their copays or other financial responsibilities like copay and deductibles? I'm a biller in new york.

One plan I know of that medicaid doesn't pay deductibles for is Fidelis Medicare advantage FLEX plan. I don't know why.

Hope someone can help me out here because I don't want to collect copays when I'm suppose to bill medicaid.

 

[sarahandross@rocketmail.com]

When a patient has Medicaid secondary you should not be collecting copays. In the advantage plan situation the advantage plans fee schedule is higher than medicaids therefore there are not going to pay anymore than the advantage plan and the copays will be a write off. The only way that they would not be a write off is if the patient has a spendown (deductible) with their medicaid. I am a biller in Michigan and that is the way that it works here. We always bill the primary and then wait for a secondary for processing before billing or collecting from the patient. =) Hope this helps some.