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Dr. Hain's Rants/Raves has helpful information about things that Dr. Hain has discovered by trial and error.

BCBS Medicare "advantage"

Medicare in name only -- watch out !


BCBS Medicare "advantage" is a new insurance product from Blue Cross Blue Shield, in place since 2017. One would think that "Medicare advantage" was a MEDICARE product, but actually it is an insurance entity resembling an HMO, that does NOT include Medicare at all.

In 2018, we have been getting 20 letters a day from BMA, stating that our practice is not "in network" with BCBS Medicare advantage, that they are taking all of the payments for our work back. In our view, this is simply fraud. They tell us that we have no contract with BCBS Medicare advantage, and thus they don't have to pay us for our work.

We now consider all BCBS Medicare advantage patients to be uninsured, at least with respect to our practice. We clearly have no contract with this insurance product. We no longer bill BCBS Medicare advantage, as although it has "Medicare" in the name, it is not Medicare, but rather it is an insurance pretending to be Medicare.




© Copyright February 13, 2018 , Timothy C. Hain, M.D. All rights reserved.
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