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  • Monthly itemized bill.

    I don't understand why I can't get a copy of the itemized bills submitted to my insurance company and Medicare. Don't you expect one from your family Dentist, Doctor, or the garage that works on your vehicles? WHAT'S THE BIG SECRET?
    All I get from my insurance company is an EOB that says "PDI' from this date to that date.
    Does anybody get an itemized bill?

  • #2
    Aetna gives itemized lists on line. You have to sign up for on line information and then I receive an update usually monthly unless I don't have a
    doctors visit. On the itemized list is shows what they pay and what my responsibility is to be. Usually, not much. Aetna takes care of what
    Medicare does not pay for and tells me what percent or co pay is expected. I am pre-dialysis but don't think it will change how they communicate with me.
    Last edited by kcramer; 03-10-2013, 01:56 PM.

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    • #3
      Thank you kcramer. I am a home hemo patient. I am looking for an itemized list of ALL the supplies and services my insurance, Medicare, and Tricare are being charged for. The only time I could get an itemized llist out of DaVita was the first 3 months I was on Dialysis and had co-pays to pay before Medicare kicked in.

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      • #4
        Hi snmiller, here is an update on where I am with figuring out cost.

        Just got my drug payment stages in the mail with my Medicare/Atnea insurance. Up to the 150.00 I pay full cost of meds. The second stage I have to put in 3,000.00 out of pocket for meds. They pay a percentage (Example: One of my meds cost 97.74 and I only pay out of pocket 25 dollars) Then in Stage 3 which is often the loop hole part is up to 5,000.00, the insurance pays more of a percentage (I don't know how much more) and I would think less than the 25 dollars for the same meds. Then in stage 5 the amount reached of 5,000.00- the insurance pays for most of the cost of medication.
        Now I will have to figure out what and where the payments for the dialysis will come from. I think I am ready to talk to the social TOPs nurse or social worker the day after the doctors appointment in April.

        This info was with information I received and I don't know if I will qualify for this since it might include my husbands income too:
        I hope this helps someone else who might need this help.
        Here are some programs to help if you are low income. "Extra Help" from Medicare 1-800 633-4227 TTY users 1-877 486 2048
        Help from state Pharmaceutical assistance programs (SPAPs) Also for different states and rules check out State Health Insurance Assistance Program (SHIP)

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        • #5
          Originally posted by snmiller View Post
          I don't understand why I can't get a copy of the itemized bills submitted to my insurance company and Medicare. Don't you expect one from your family Dentist, Doctor, or the garage that works on your vehicles? WHAT'S THE BIG SECRET?
          All I get from my insurance company is an EOB that says "PDI' from this date to that date.
          Does anybody get an itemized bill?
          SNMiller,

          You can call CMS and request and itemized bill. If they automatically sent out an itemized bill for everyone, it would be a big waste of paper as most dont read them and they go directly in the trash.
          ______________________________
          PD - 13 Years
          3 Transplants
          In-Center Hemo - 6 Months
          NxStage - Since April - 06
          Facebook: Dialysis Discussion Uncensored

          ________________________________

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          • #6
            M3Riddler
            I don't request billing. They just send it from the mail in pharmacy. The insurance company has everything else itemized on my website log in page.

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            • #7
              Originally posted by snmiller View Post
              Thank you kcramer. I am a home hemo patient. I am looking for an itemized list of ALL the supplies and services my insurance, Medicare, and Tricare are being charged for. The only time I could get an itemized llist out of DaVita was the first 3 months I was on Dialysis and had co-pays to pay before Medicare kicked in.
              I think I know why you get no list. Medicare and Tricare pay a flat rate and it does not matter how many supplies you get, they will be charged the same monthly rate. From what I've seen on other bills it is about one fifteenth of the rate charged on insured patients. It is still frightening how much it costs. I cannot imagine who could afford the uninsured rate.

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              • #8
                I would like an itemized bill for my spenddown

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                • #9
                  Hi, I have Humana supplement to Medicare and Humana provides Davita Services claim detail showing only a daily charge from Davita Services provider, amount Humana plan paid for, and 20% to be paid by me until I reach my Out Of Pocket detail. No detail on supplies.

                  Darko.

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