When will we find out if we owe anything to Medicare?

Annita asked...

My mom had a stroke and was in and out of hospitals, ICU, emergency, nursing homes and hospice for 2 months. She passed away last November.She left her home for all 7 of her children but we don't know if we owe anything to Medicare. How long do we have to wait to find out? Thank you, Anna

Expert Answer

Whenever someone receives a Medicare-covered medical service, Medicare registers all the administrative details of that service -- such as who provided it, when, how much Medicare does and does not pay, and how much the patient (or the patient's other insurance) is responsible for. It then collects all the information for services provided for each three-month period and mails the patient a detailed summary called a Medicare Summary Notice. So, check your mother's mail for this Summary Notice. The notice is sent every three months, but there is often a delay between when a service is provided and when it makes it through the administrative systems of the providers -- doctors, hospitals, nursing homes etc. -- and then Medicare's system. So, services your mother received in November, for example, might not show up in the Medicare Summary Notice sent in the first quarter of this year, and might not appear until the second quarter's notice. In other words, you might not get a final accounting from Medicare until as late as June of 2011.

When you receive the Notice, it will tell you all of the yearly Medicare Part A and Part B deductibles and any copayments your mother (now, your mother's estate) owes for hospital, nursing home, hospice, doctors and other provider bills. Your mother's estate does not owe these amounts to Medicare. Instead, the Medicare Summary Notice tells you what amounts the providers were allowed to charge (the Medicare-approved amount) and how much of those amounts Medicare paid. The remaining, unpaid amounts are owed to the providers themselves, not to Medicare. So, your mother will be receiving bills directly from these providers. Any bill your mother receives from one of these providers should match the amount shown on the Medicare Summary Notice. If there is a difference in the amounts in a bill and what's shown in the Medicare Summary Notice, contact the provider and ask for an explanation. If the bill is not corrected, or if the explanation does not satisfy you, the Medicare Summary Notice itself gives you information on further steps to take.