Wiki Medicaid not covering full $166 medicare deductible.-Is anyone else

[JesseL]

Is anyone else having issues billing medicaid for the full $166 deductible?

New York medicaid is telling me they wont pay for deductible amounts over $150. I'm telling them Medicare's new deductible is $166, they don't know what I'm talking about and insisted the charges are invalid. It's like talking to a wall with them and it was meaningless arguing with them.

So they're basically telling me they consider any charges over $150 to medicaid to cover medicare's deductible is invalid.. Are they not updated with medicare's new deductible or something?

 

[thomas7331]

My experience with Medicaid plans in various states has been that they often do not pay all of the patient's deductible or coinsurance. Usually it's because when the primary payer has already paid more than the local current Medicaid rate, they consider the claim paid in full. Unfortunately, if you're participating with Medicaid, you really don't have much choice other than to accept their rules, however illogical or unreasonable they may be. Either way, the reps you call should be able to give you an explanation - if they can't, I'd escalate it to a supervisor or provider relationships representative. If that fails, calling a complaint in to your elected state senator or representative will certainly get you a return call.