What's the deal with Farm Bureau Med Supp

[junkman]

I talked to a local FB office. They don't pay commissions and their agents don't bother selling them. Instead there is "a girl" who is "certified" and does all of the enrollments for an area. Of course that means you have no agent to advocate for you when claims are denied.

But they're cheap.

 

[VolAgent]

I talked to a local FB office. They don't pay commissions and their agents don't bother selling them. Instead there is "a girl" who is "certified" and does all of the enrollments for an area. Of course that means you have no agent to advocate for you when claims are denied.

But they're cheap.

I'm not going to say I'm a fan of FB, but how often are claims denied? I thought Med Supp claims were pretty straightforward, if Medicare pays, the Med Supp pays.

 

[Chazm]

I'm not going to say I'm a fan of FB, but how often are claims denied? I thought Med Supp claims were pretty straightforward, if Medicare pays, the Med Supp pays.

Exactly .

 

[vic120]

I'm not going to say I'm a fan of FB, but how often are claims denied? I thought Med Supp claims were pretty straightforward, if Medicare pays, the Med Supp pays.

You know what though, I do get clients misbilled from time to time and its good they have an agent like me who will call and get to the bottom of it

I have had 3 clients this year who were misbilled and I had a bill squashed

 

[WCMason]

I'm not going to say I'm a fan of FB, but how often are claims denied? I thought Med Supp claims were pretty straightforward, if Medicare pays, the Med Supp pays.

You are correct that the supplement can't decline claims whenever they are secondary to Medicare, as the CMS contractor makes all coverage decisions and the Medigap must follow their decision.

This thread is about an old pre-standardized Medigap that offered 265 days additional--and primary--SNF coverage after Medicare's 100 days is exhausted (the OP didn't say it was pre-standardized, but the benefit in question tells us that). Once Medicare was out of the picture on the 101st day, the Medigap carrier determines medical necessity, not unlike they do for the foreign travel benefit Medicare doesn't cover.

AARP also had this 265 day SNF feature after the 100 days more than 20 years ago when their dance partner was Prudential.

 

[junkman]

This is an old contract.

You are correct that the supplement can't decline claims whenever they are secondary to Medicare, as the CMS contractor makes all coverage decisions and the Medigap must follow their decision.

This thread is about an old pre-standardized Medigap that offered 265 days additional--and primary--SNF coverage after Medicare's 100 days is exhausted (the OP didn't say it was pre-standardized, but the benefit in question tells us that). Once Medicare was out of the picture on the 101st day, the Medigap carrier determines medical necessity, not unlike they do for the foreign travel benefit Medicare doesn't cover.

AARP also had this 265 day SNF feature after the 100 days more than 20 years ago when their dance partner was Prudential.

Yes. This.

I didn't work with medicare back when this contract was written and had to figure it out rather than having the data stored securely deep in my brain history. The next step is to confirm that the correct code was used when filing and document that the services were for acute illnesses and not simply to help with for example ADLs.

It is interesting that Medicare covered the first 100 days and FB declined day 101 and onward.