Kmeb:

I have a Medicare HMO (same one as Alan) and we both have medicare Part D. That's how we get our meds, (antibiotics, Alan's zoloft, etc.). We pay $8.00 per generic med. We rarely use the formularies because a co-pay for that is $28.00. Alan gets generic zoloft, so he only pays $8.00.

Now when Alan was first talking about getting the IVIG, I was on the phone with the IVIG people and they told me "it's all in how the doctor bills it, if he or she bills it under Medicare Part D, you'll be screwed because you'll hit the donut". But if it's billed under Durable Medical Equipment, then it's a whole other ball of wax. I remember the conversation.

So I made sure they knew what to do, and since this neuro knows what to do, she knew how to bill it.

I believe it's all up to the doctor's and the billing department and they know which codes to put in. It's always about the codes.

I'm still getting letters from the Diagnostic place where I had a shoulder x-ray. They keep telling me "your insurance refuses to pay for this x-ray". When I call my insurance, they tell me "tell them to put the right code in".

I did. Haven't got a letter since. It's all about how it is billed. At least it was in our case.

Mel