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Has anyone heard about this Network?
With my wife dealing with the financial aspects of her mother’s recent passing she has been dealing with the final hospital bill. When she received the final EOB from the insurance company at the bottom there was the following:
“(Her hospital) participates in the USA senior Care Network program. The part A deductible of $1,676 will be waived by the hospital. No benefits are due.”
From what I have been able to glean from the website many insurance companies participate in this program in which participating hospitals will waive all or part of many deductibles. This is for those with traditional Medicare with participating supplemental insurance companies only.
Some additional information from the network’s website:
Every patient that is incentivized to use your hospital through our program has complete supplemental coverage for all claims. This includes patient responsibility payments for lengthy admissions, all outpatient co-payments, and coverage for exhausted accounts.
Medicare Supplement Facilities Network
USA Senior Care Network offers Medicare Supplement carriers an opportunity to decrease the cost of Medicare Supplement insurance to existing Medigap policyholders by helping reduce the severity of premium rate increases. Our program is an excellent retention tool for carriers.
USA SCN owns the largest directly contracted Medigap facility network in the United States. Each of our contracted facilities has agreed to waive all or a portion of the Medicare Part A deductible.
This is a program that positively impacts all involved stakeholders. Carriers that participate in the Network will realize significant savings from the elimination or reduction of the Part A deductible, which benefits its insureds by helping curtail premium increases.
Medicare Select Facilities Network
USA Senior Care Network has entered into agreements to provide a national Medicare Select Network consisting of over 1,600 facility locations that have agreed to waive all or a portion of the Medicare Part A deductible. Select providers have been carefully chosen and fully credentialed. Medicare Select carriers can offer their insured members extensive network coverage.
For more information this is the network’s website
In a 2022 sponsored business profile this apparent private for profit Texas company described their business model which included the following –
our Medigap carriers’ seniors know that by using
doctors and hospitals within our network,
their premiums stay affordable, so they are
more willing to change hospitals to find one
within our network
A big part of my decision to utilize traditional Medicare with a supplemental policy was to not be limited to a network.
Thanks but not for me.
Hey Bill,
Thanks for the article. After reading it I get why you wrote what you did. The article makes it sound like a Medicare Advantage version of Medigap but it is not. If you have an insurer who is in the network your participation is not mandatory. It is the insurer who can join the network but participation by the insured is totally voluntary. As an example my mother in law was living independently she went to doctors and a hospital which she chose who were not participating in the network. When she came to live with us she continued going to her doctors office choice but when she had an emergency we chose to have her transported to the hospital near to us which we utilize.
This hospital is in the Massachusetts General Hospital/Brigham group and unbeknownst to us they are in the USA Senior Care Network. Because the hospital is participating in the network the hospital waived the hospitalization deductible. Because the hospital was erroneously asking for payment from my mother in law conflicting with the information from her insurer we called the network, they called the hospital to inform them they could not ask for the deductible payment and the bills stopped.
We learned from the network that if you know your insurance carrier is part of the network you can call their number and tell you which hospitals and MD practices are participating. The insured decides whether they want to receive care from a participating provider. Again it is not at all mandatory.
Good morning David,
I commend your wife and you for stepping up to care for your mother in law at her time of life she needed help. I am forever grateful and impressed by unselfish family love in action which happens every day. I have seen such acts of love and sacrifice multiple times in my own family and appreciate those who do so.
In regards to entity you reference I am mentally trying to follow the money. I still conclude that such referral services intended to drive patient revenue to a particular medical system to financially benefit that hospital or save the insurance company a otherwise valid fee for a service rendered is a zero sum event to the parties involved except for the company using a patent to facilitate such fees. Your diligent review and action kept personal assets of the patient from being expended to pay for an amount the hospital and medigap insurance company agreed to waive for their own financial benefit.
Howard Rohleder had a 8/3/2022 HD article that your forum article reminded me of. In an emergency will I shop for the lowest price for medical care or will I utilize the best and fastest point of service? I think in an emergency that shopping for medical services will not be a consideration for me.
I am glad your mother in law has you in her corner.
Best, Bill