Medicare & Medicaid
Allegiance Health is a participating provider with Medicare. The hospital has signed a contract with Medicare to provide services to entitled beneficiaries. Medicare patients will be billed only for deductibles, co-pays and some non-covered charges.
Medicare supplemental insurance
If you have additional insurance coverage besides Medicare, Allegiance Health will bill your supplemental insurance company for any amounts Medicare does not pay. Medicare supplemental and retirement plans may not cover the entire balances after Medicare. Amounts not paid by Medicare or other insurance will be your responsibility.
Medicare as a secondary insurance
Medicare will not cover you for your primary insurance if:
- You or your spouse is still working and is covered by an employee group health plan
- Your were involved in an automobile accident
- You were injured and some other party may be liable for the injury. This includes Workers’ Compensation claims for Medicare insured persons who are still working
In these cases, please provide information regarding the employer group insurance, automobile coverage, or the Workers’ Compensation claim. A Medicare claim will be submitted for any balance the primary insurance does not pay.
Allegiance Health is an approved Medicaid provider. This means the hospital has signed a contract to provide services to Michigan Medicaid recipients. If you have active Medicaid coverage, Allegiance Health will bill the Medicaid program. We ask that you provide us with information about any supplemental and retirement insurance you may have. If you have other insurance coverage, Medicaid will not pay until the other insurance has paid or denied payment. This includes automobile insurance for injuries related to a motor vehicle accident.
Charges not covered by Medicaid
Some charges are not covered by Medicaid. Allegiance Health will inform you of the cost of any non-covered services and ask you to sign a Notice of Non-coverage; this is your written agreement to pay for uncovered services in full. Federal law requires that itemized medical claims for Medicaid recipients be sent directly to the Michigan Department of Community Health. A Medicaid patient may subpoena a copy of their billing from the State of Michigan.
Allegiance Health has a number of resources to assist uninsured patients with applications for Medicaid or other assistance that may be available to help with medical expenses:
- Patients in the hospital now, call (517) 788-4973.
- Patients planning care in the future, call (517) 788-4973.
- Patients who have already received care, call (517) 788-4920.
When Medicaid coverage is denied
If you are denied Medicaid coverage, Allegiance Health may refer you for assistance in appealing the denial or may be able to offer other assistance. To access help when denied by Medicaid, please call (517) 788-4920.
Medicaid managed care
Medicaid contracts with insurers who manage the medical care of patients receiving Medicaid. These insurers are known as Medicaid managed care providers. Allegiance Health has contracts with Medicaid managed care providers, including Priority Health, Great Lakes Health Plan of Michigan. These providers usually require authorizations before any services are provided. It is your responsibility to work with the insurance provider to obtain any required authorizations. Allegiance Health will assist in this process whenever possible.
Allegiance Health accepts an assignment of benefits for most commercial carriers. A statement from the hospital will be sent to you 30 days after services. If the insurance company fails to pay the claim within 60 days, you will be billed for the balance on the account.
Medical claims and itemized bills
If your physician recommends that you see an Allegiance Health provider (including a hospitalist, specialist or internist) during the course of your admission, you and your insurance company may receive multiple bills from Allegiance Health.
This billing falls under the same guidelines as the hospital bill regarding participating insurances and patient responsibilities.