Medicare question

[ctmsmom]

I was just wondering. when I go to my primary care physician and now having Medicare... do I need to give them the card to let them know that I now have Medicare... or do they already have access to the fact that I now have Medicare. Is it in some kind of online system? Or do I need to even say anything.I would rather not

At this point in time I am going to decline part b and keep my husbands employers insurance which is on file at the doctors office.

Also. I am concerned about privacy. A lady that works in the doctors office has a child that goes to my daughters school and does not understand that ms is an invisible disease. I really don't want the whole school knowing that I have Medicare. It was hard enough realizing I could not work and accepting disability. Now having people know everything about me... I really don't want that to happen.

Can anybody give me some feedback. Thanks

[CrazyCatLady]

Ok I can help with this as up until MS knocked me for a loop I did medical billing for a family practice office. OK if you are only getting part A, the free hospital only coverage, and are NOT getting part B, the doctor office coverage, there is no reason to tell your doctor's office. They will continue to bill the insurance that you still have through your husband. There is no reason for them to know that you have part A. However...if you go to a hospital for any care, they need to know that you have part A coverage.
Hope this helps!!
P.S. There is an online way for the doctor's office to look up your Medicare coverage but they would have to know that they should be looking, which in your case they don't need to bother. I hope I made sense here. The MS fog haunts me sometimes. LOL!

[Redwings]

Hi ctmsmom:
KarenLeah summed up the coverage issue nicely. If you don't have Part B, then you don't have anything to be telling your primary care physician's office about. As far as your PCP's office is concerned, you don't even have Medicare.

Privacy is a different issue. Since you don't have Part B, your PCP's office revealing that you have Medicare isn't even an issue. But even if you were to use Part B for your PCP visits, there is no way for anyone to connect the simple fact that you have Medicare coverage with you having MS. The only way for anyone to know you have MS is for someone to specifically tell them that. That's entirely different than someone just knowing what kind of medical insurance you have. It seems like your embarrassment about qualifying for Medicare has made you a bit sensitive about remote possibilities.

Medical providers and their staffs, and medical insurers and their staffs, are bound by the privacy rules of the Health Insurance Portability and Accountability Act (HIPAA). The rules can't prevent breaches of privacy by those entities, but they allow for penalties.

Technically, the mere act of someone on your PCPs staff telling anyone other than your medical insurer that you're a patient in their office is a breach of your privacy and a violation of HIPAA. Revealing what kind of medical insurance you have (including your current coverage) to anyone not involved in your medical care is a breach of your privacy. Revealing any personal information about you to any entity not involved in your medical care is a breach of your privacy. And revealing anything about your medical condition or medical history to any entity not involved in your medical care is an egregious breach of your privacy.

You're obviously concerned that the person in your PCP's office might tell her child about you. (Do you have any reason to believe that she might do that?) That would be a violation of HIPAA, and your PCP would be subject to penalties for allowing a staff member to violate HIPAA policies. You might also be able to recover damages by suing in civil court.

Regarding HIPAA, there are a couple of things to bear in mind. First, the interaction between insurers and medical providers allows, out of necessity, for the free exchange of a lot of personal information. But it still must be directly related to the provision of and/or payment for care. Second, HIPAA applies only to insurance providers and medical personnel and their staffs. It does not apply to private citizens. So, for example, if one of your neighbors has the same doctor and tells your other neighbors that they saw you at the doctor's office, and you would prefer that no one else knows about it, that would not be covered by HIPAA.

[ctmsmom]

Thank you so much for responding back to me. I really appreciate it. I was just worried that with the way the ladies/moms gossip at my school that this lady would make me feel uncomfortable about having to be on medicare. I don't think some people fully understand the disease... I can walk... so they think I am fine. I try not to tell people the many other symptoms that I have. I think they think ms is like a cold or something.... and that it will get better and go away. It was a hard thing for me to accept that I can't do what I used to do and parents call be brutal!!! Thanks again. When I go to the doctor tomorrow.. I can feel comfortable about being there and not being looked at funny.