Aurora Medical Center – Bay Area, Marinette, 2020 Community Benefit

When Coverage Doesn’t Pay Prior Medical Expenses

Edwin reached out to the Financial Advocate at Aurora Medical Center-Bay Area in December 2019 asking for financial help. 
When the hospital’s Financial Advocate worked with him at that time, Edwin indicated he did not have insurance. Through a financial assessment, the Advocate discovered that he did have some coverage through Medicare Part A but that it didn’t work the same way Medical Part B works.
In July 2020, Edwin added the Medicare Part B to his coverage but would have to pay back the Part B premiums for the months he did not have the coverage. This requirement almost works like a “penalty” for not taking Part B when Edwin originally began Part A coverage. This was new information to the Financial Advocate, and she filed this information in her memory so that she could share this with future patients she worked with. In addition, Edwin’s coverage would not cover all the expenses he already incurred.
In the end, although Edwin needed a lot of assistance from the Advocate, he was willing to do whatever he needed to get the help felt he so desperately needed. Following a financial assessment, the Advocate was able to Edwin get approval for a financial hardship program, a payment plan for some past expenses, and eventually, Medicaid to cover any future medical expenses he may incur.
Edwin was grateful for all the help he received, and his experience was a reminder for the Advocate about why she loves the work she does.