Medicaid and Medicare Patients

Medicaid Patients

If you have Medicaid coverage, you must show your card each time you visit the hospital so that we may verify with Medicaid that you are eligible to receive coverage. Your primary care doctor must refer you to Stephens County Hospital before Medicaid will pay for your hospital services.

Medicaid does not pay for certain services even if your doctor orders them. You may need to pay all or a portion of the charges that are not covered. Please call your Department of Social Services (DSS) worker to make sure Medicaid will cover the procedure. We have staff available to assist you in determining if you qualify for Medicaid benefits.

 

Medicare Patients

If you are a Medicare patient, you will be asked a series of questions regarding your retirement and any other insurance you may have. These questions are required by law and must be asked every time you receive services.

We may need to bill your insurance company before we send the bill to Medicare. If you are covered by a group insurance or have a change in employment, please let us know when you register at the hospital. A change in your job or your spouse’s job may affect how we are required to bill Medicare.

Medicare determines when a service is medically necessary. In the event that a service is not covered by Medicare, we may ask you to sign an Advance Beneficiary Notice (ABN). By signing the ABN, you agree to pay for services that Medicare will not cover. Additionally, we will bill you and/or your supplemental insurance carrier for services not covered by Medicare, such as routine health exams, self-administered drugs, and any tests Medicare deems as not medically necessary.

You will be responsible for payment if neither Medicare, nor your supplemental insurance carrier, agree to cover your services.