Medicare Supplement G Provider

[VincentD104420]

Hi! My brother has(will be had) WellAbe for his supplement G. He has had knee surgery a bout 3-4 years ago. He went to the doctor to check why he doesn't have full use of his leg. He limps. He also went to get his hearing checked. He knows he needs a hearing aid,and the ones he's tried, to put it bluntly, suck. He received his bills, and this WellAbe won't honor any payments. They tell him now that they don't cover these type of medical issues. Are there any companies that cover this? Any recommendation for a supplement G insurer? Any and all responses will be greatly appreciated. Thanks.

[GailL1]

WellAbe Medicare Supplemental Plan G is secondary insurance - it work WITH Original Medicare. The billings go thru Original Medicare 1st and then are usually sent automatically to your Supplemental carrier for them to pay their part.

But hearing aids are not covered under Original Medicare.

Your brother or you and your brother should read or listen to “Medicare and You”

Because he is very confused - this will at least give you some foundation.

Medicare.gov - Medicare and You 

You could also meet with a SHIP (State Health Insurance Programs) agent in your state - they are a free government service - locate them thru your states Dept of Insurance.

OR you can go talk to a local INDEPENDENT Medicare Insurance broker or agent - they will look at the plan he has now, explain it and explain the difference in Original Medicare (where Plan G works with Original Medicare) and Medicare Advantage plan (they have some hearing coverage- but Plan G does not work with a Medicare Advantage plan)- They will look at his needs and then give some recommendations but that might have to be done at a later time depending on your brothers situation.

[TRL1111]

Supplements have no say over what they cover.  Their only role is if Medicare approves a charge, Medicare pays 80% and the supplement pays 20%. 

Medicare Part B (e.g. office visits) has a $283 deductible. The supplement doesn't start paying anything until the patient has paid $283 toward Medicare-approved medical expenses.  Once that is paid by the patient, the supplement starts paying its 20% and the patient owes nothing.

Is it possible your brother is being billed by the provider because he hasn't met his $283 deductible yet for this year, and he owes the entire Medicare-approved charge until he hits $283?

Also, all Plan G supplements provide the same coverage of Medicare expenses, so your brother isn't going to get any different coverage of Medicare-approved expenses from one company than another.  Some offer some extras like a gym membership, but it's fairly rare for supplements (much more common with Advantage plans).  But that has nothing to do with covering doctor visits.

Medicare does not cover hearing aids, and therefore neither will a supplement.  Some supplements have as an "extra" a discount on hearing aids, but it's not common, and is always restricted to a particular network of providers so you can't just go to anyone if you do have a supplement with an "extra" hearing aid benefit.  And any such "extras" are separate and apart from any Medicare coverage.