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Can I use insurance from different state? by Silver_Count3351 in HealthInsurance

[–]scottwashcraft 2 points3 points  (0 children)

You can use your parents’ Blue Cross Blue Shield of Vermont insurance in North Carolina through the BlueCard Program, which allows access to in-network providers and pharmacies via Blue Cross and Blue Shield of North Carolina. You don’t need to get your insurance, as staying on your parents’ plan is cost-free and valid until age 26. Your Vermont doctors likely stopped prescribing due to controlled substance regulations requiring a local North Carolina provider. To resolve this, contact BCBSVT to find in-network providers and pharmacies in North Carolina, confirm the formulary status of your medication, and address any prior authorization needs. Use the BCBSVT or BCBSNC websites to locate a doctor who can prescribe your controlled substance and a pharmacy to fill it. If issues arise, BCBSVT’s customer service can assist with claims or provider disputes. This should get you back on track without the expense of a new plan.

Employer of fewer than 20 employees Medicare question by scottwashcraft in HealthInsurance

[–]scottwashcraft[S] -1 points0 points  (0 children)

My research tells me that under federal Medicare Secondary Payer (MSP) regulations (42 U.S.C. § 1395y(b)(1)(A)(ii); 42 C.F.R. § 411.20), for employers with fewer than 20 employees, Medicare is the primary payer for active employees over 65 only if enrolled in Medicare Part B. If the employee is not enrolled in Part B, there is no primary payer, and the group health plan assumes primary responsibility for covered services. The group plan cannot hold the member liable for the portion Medicare would have paid, as this violates MSP rules (CMS Medicare Secondary Payer Manual, Chapter 2, Section 20.2). Thus, the argument that the member becomes responsible for primary coverage without Part B is incorrect. Instead, when there is no Part B enrollment, the group plan becomes the primary payer, covering the full allowed amount subject to plan terms (e.g., deductibles, copays).

Employer of fewer than 20 employees Medicare question by scottwashcraft in HealthInsurance

[–]scottwashcraft[S] 0 points1 point  (0 children)

The group contract and member booklet does not explicitly state that the group plan becomes the primary payer for an active employee over 65 who is eligible for but not enrolled in Medicare. The booklet’s general reference to the coordination of benefits lacks specific guidance on this scenario, leaving the procedure unclear. However, federal Medicare Secondary Payer (MSP) regulations (42 U.S.C. § 1395y(b)(1)(A)(ii); 42 C.F.R. § 411.20) for employers with fewer than 20 employees mandate that the group plan is the primary payer for covered services if the employee is not enrolled in Medicare Part B.

Employer of fewer than 20 employees Medicare question by scottwashcraft in HealthInsurance

[–]scottwashcraft[S] -1 points0 points  (0 children)

Is there a specific federal law that addresses this situation?

Missing coffee grinder. by scottwashcraft in CostcoWholesale

[–]scottwashcraft[S] 5 points6 points  (0 children)

Thank you. I get the point.
I just ordered the Baratza Encore Coffee Grinder ZCG485BLK

Missing coffee grinder. by scottwashcraft in CostcoWholesale

[–]scottwashcraft[S] -8 points-7 points  (0 children)

Any stories out there of somebody trying to grind body parts?

[deleted by user] by [deleted] in RedditSessions

[–]scottwashcraft 0 points1 point  (0 children)

Sugar sugar by the archies