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Show Wednesday, October 29, 1986 Sun Advocate, Price, UtahSB Social Security issue is clarified ARCHULETA By HERMAN Social Security representative Medicare beneficiaries may think that once their Medicare protection starts, it will always pay first for hospital and medical bills. This isnt always true. There are times when Medicare is the secondary that health insurance payer is, when it pays after other sources pay for services. are three There major situations where Medicare is the secondary payer. If a beneficiary is entitled to Medicare solely on the basis of permanent kidney failure and is covered by an employer group health plan, Medicare is the secondary payer for an initial period of up to 12 months. The employer health plan pays first for kidney treatment and other health services during that time. If the employer plan doesnt pay in full, Medicare may make secondary payments to supplement the amount paid by the employer plan. Medicare becomes the primary health insurance payer at the end of the period. Medicare also is the secondary payer for beneficiaries 65 or older who have employer group health coverage through their employer or through their spouses employer. Under a special rule, employers with 20 or more employees must offer workers and their spouses 65 or older the same health insurance protection that is available to younger workers. The worker can accept or reject the employer health insurance plan. If the worker accepts the employer plan, Medicare becomes the secondary payer and can only help pay for any Medicare-covere- d services that are not paid by the employer plan. who have Beneficiaries th health group employer coverage should be sure to tell hospitals, doctors or others who provide medical services so that the services will be billed correctly. In addition, Medicare is the secondary payer when health care services are covered under automobile medicare ininsurance, state automobile liability surance, insurance, or other liability insurance. This is true even if state law or the private insurance contract says that the or other automobile, liability benefits are secondary to Medicares. If the automobile or insurance refuses to pay for services, Medicare payment will be conditional. This means Medicare will make payment on the condition that the Medicare patient will refund the money if no-fa- Kenmore 100 waft dual tape stereo freezer 30099 . meas. picture. ih. Refrigerator- - 649.99 Split cantilever shelves 20.6 cu. ft Dual cassette decks rack included iannel display $598 Reg. Premium extra-capaci- ty Kenmore Premium washer 39999 Reg. 509.99 Premium extracapacity dryer 379.99 in '86 Spring Gen. Cat. 299" Microwave oven 459.99 299" Large-capaci- ty Auto defrost colors extra White, Cotton 29,ea. Regal Cookware 7 Pc. Set $24 87461 mriore Kenmore canister vac right vac id 7999 racer wrap cord Reg. 279.99 ns is 10 179" West Price River Drive 9:30-- 6 Sat. 10-cu- 3-i- Kenmore n-l Built-i- n microwave Reg. 219.99 $166 Counter top, undercounter, dishwasher Reg. 399.99 p 29999 24-i- n. model Reg. Sale Rebate your cost after rebate contact their local Social Security office or call toll-fre- e March of Dimes (ft Drip Coffee Maker 24.99 16.99 7.00 9.99 Medicare cannot pay for services which are payable by any workers compensation plan, the federal black lung program, or the Veterans Administration. Payment from these sources is considered payment in full and Medicare has no liability. For more information about these secondary payer rules, Medicare beneficiaries should wash wall-mou- nt Brackets extra Includes attachments advertised. readily available for sale as rton;-Fr- i. Your choice 19.99 Twin and Full 24.99 Queen and King 29.99 3.9 HP (peat) 1.10 (VCMA) ight, Kenmore Bedspreads and Comforters that is remember should Finish Non-stic- k no-fa- ult the automobile or liability insurer later pays for the services. If a beneficiary receives medical services as the result of an accident, he or she should tell the health care provider about the accident and furnish information about all insurance policies or other parties who may be liable for medical expenses. Another rule beneficiaries Bath Towels 100 no-fau- lt, SEARS SAVES BABIES HELP FIGHT BIRTH DEFECTS |