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 FREQUENTLY ASKED QUESTIONS
 
Medicare Supplement:
Q: Are Electronic Payments offered for Medicare Supplement Products?
Q: How do I submit a claim?
Q: What are the benefits on the Medicare Supplement policy?
Q: How do I submit an Electronic Medigap Claim?
Q: How do I submit a Paper Medigap Claim?
Q: What is our procedure/policy for paying?
Q: Must hospitalization be pre-certified for a person that has a Medicare Supplement Policy?
Q: What address should be used when mailing a claim?
Q: How do I delete my online account?

 


Medicare Supplement:

Q: Are electronic payments offered for Medicare Supplement Products?
Yes. We are now offering Electronic Payment and Electronic Explanation of Benefits for Medicare Supplement Products. CLICK HERE FOR MORE INFORMATION.

Q: How do I submit a claim?
Please submit a copy of the Medicare Summary Notice (MSN) also known as the Explanation of Medicare Benefits (EOMB). Each document must include the control number on the document. This will be noted as the ICN number.

Q: What are the benefits on the Medicare Supplement policy?
BASIC BENEFITS Included in all plans:

" Hospitalization: Part A co-insurance after the 60th day of hospitalization.
After the 90th day of hospitalization, the current lifetime reserve co-payment amount will be paid until the insured uses up all of his or her 60 Lifetime Reserve Credit Days.
 
Once 60 Lifetime Reserve Days are used up and Medicare Benefits end, the policy will pay Medicare Part A eligible expenses for up to an additional 365 days of hospitalization.
"
 Medical Expenses: Part B co-insurance (20% of Medicare eligible expenses)
"
 Blood: First 3 pints of blood each year
"
 Hospice: New benefit as of 2010, by MIPPA, includes cost-sharing for all Part A Medicare eligible hospice case and respite care expenses. 
These are the basic benefits and each plan may cover more expenses.  Please check your individual plan for full list of policy benefits. Q: How do I submit an Electronic Medigap Claim?
1. If you want claims to be submitted directly to Colonial Penn after Medicare has paid, the following needs to be completed on your electronic submission to Medicare. 2330B loop (Other Payer Information) needs to be completed.
2. Enter on NM101: PR (payer)
3. Enter on NM102: 2 (non Person entity)
4. Enter on NM103: Colonial Penn 
5. Enter on NM108: PI (payer identification code)
6. Enter on NM109 : 55000 Q: How do I submit an Paper Medigap Claim?
1. In Box 9 enter the last name, first name and middle initial of the insured if it is different from that shown in block 2.
2. 9A Enter the policy number of the insured proceeded by Medigap, MG or MGAP.
3. 9C Enter the Colonial Penn administrative mailing address. (PO Box 1935, Carmel, IN 46082-1935)
4. 9D Enter the 5 digit Medicare ID code 55000
Q: What is our procedure/policy for paying?
Our general policy for paying Medicare Claims is based on Medicare's approval of the claim. If Medicare approves the claim for payment we will consider the coinsurance due and or deductable amounts based on Medicare's approved amounts. (Percentages may vary based on the plan.) If you are seeking pre-approval on a medical visit or procedure, please contact Medicare. Q: Must hospitalization be pre-certified for a person that has a Medicare Supplement Policy?
No. For a policyholder to enter the hospital, they do not need to contact Bankers for pre-certification. However to guarantee the visit or procedure will be approved by Medicare, please contact Medicare.

 

Q: What address should be used when mailing a claim?
For Medicare Supplement: Send a copy of Medicare's Explanation of Benefits to:
Policy Benefits Dept.
PO Box 1935
Carmel, IN 46082-1935 Q: How do I delete my online account?
If you no longer wish to have access to policy and claim information through the Healthcare Provider Services site, please contact our Customer Service Center to delete your online account.