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 FREQUENTLY ASKED QUESTIONS
 
Medicare Supplement:
Q: Are Electronic Payments offered for Medicare Supplement Products?
Q: What types of deductibles are available under Bankers Life and Casualty Company Medicare Supplement plans?
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?

 

Long Term Care:
Q: Are Electronic Payments offered for Long Term Care Products?
Q: How do I file a Claim?
Q: Best way for me to check if a patient has maxed out their benefits
Q: Best way to check the remaining benefits
Q: What address should be used when mailing a claim?



Medicare Supplement:

Q: Are Electronic Payments offered for Medicare Supplement Products?
Yes. We offer Electronic Payment (EFT) and Electronic Remittance & Advice (ERA) for Medicare Supplement Products. Enroll here.

Q: What types of deductibles are available under Bankers Life and Casualty Company Medicare Supplement plans?
We offer the following deductible options based on the insured's Medicare Supplement plan as specified on their ID card:

  • Part A deductible
  • Part B deductible
  • Plan F high deductible
  • Plan K Out of Pocket Limit
  • Plan L Out of Pocket Limit

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 Bankers 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: Bankers Life & Casualty
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 Bankers 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.
Long Term Care:

Q: Are Electronic Payments offered for Long Term Care Products?
At this time, Electronic Payment and Electronic Explanation of Benefits are not offered on Long Term Care Products. Q: How do I file a Claim?
Please include:
 
  •  Claim form completed in full
  •  Itemized Bill (UB-04, UB-92, HICFA-1500). This form should include:
    •         Date(s) of service(s)
    •         Cost(s) of service(s)
    •         Amount of units per service 
    •         Diagnosis(Dx) Codes (Ex. 123.45)- What's wrong with the policyholder
    •         CPT Codes (Ex. 12345)- What services were received
  • Copy of your license 
  • Copy of your plan of treatment
You may be contacted by Bankers for further details regarding the policyholder's claim. Q: Best way for me to check if a patient has maxed out their benefits:
Currently the only way is to contact our Customer Service Department at:
800-621-3724
Note: We have a project underway that will make this available on-line in the not too distant future. Q: Best way to check the remaining benefits:
Contact our Customer Service Department at 800-621-3724 during regular business hours 7am-7pm CST. Q: What address should be used when mailing a claim?
For Long Term Care and Home Health Care, send all requested documents to:
Bankers Life and Casualty Co.
Policy Benefits
PO Box 1902
Carmel, IN 46082-1902