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Member |
My previous post didnt quite answer the question I think you were asking, but I wont delete it. It might have some info useful to others. I think you're looking for this: Coordination of benefits If you have Medicare and other health coverage, you may have questions about how Medicare works with your other insurance and who pays your bills first. Each type of coverage is called a “payer.” When there’s more than one payer, “coordination of benefits” rules decide who pays first. The “primary payer” pays what it owes on your bills first, then you or your health care provider sends the rest to the “secondary payer” (supplemental payer) to pay. In some rare cases, there may also be a “third payer.” Whether Medicare pays first depends on a number of things, including the situations listed in the chart on the next 3 pages. However, this chart doesn’t cover every situation. Be sure to tell your doctor and other providers if you have health coverage in addition to Medicare. This will help them send your bills to the correct payer to avoid delays. Where to go with questions If you have questions about who pays first, or if your coverage changes, call the Benefits Coordination & Recovery Center (BCRC) tollfree at 1-855-798-2627. TTY users can call 1-855-797-2627. The BCRC is the contractor that acts on behalf of Medicare to collect and manage information on other types of insurance or coverage that a person with Medicare may have, and determines whether the coverage pays before or after Medicare. This contractor also acts on behalf of Medicare to get repayment when Medicare makes a conditional payment, and another payer is determined to be primary. When you call the BCRC, have your Medicare Number ready—you can find it on your red, white, and blue Medicare card. The BCRC may also ask for information like your Social Security Number (SSN), your address, the date you were first eligible for Medicare, and whether you have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance). 6 Section 1: When you have other health coverage How Medicare works with other coverage–find your situation Find your situation on pages 6 through 8 to see which payer generally pays first for Medicare-covered items and services, and which page to visit for more details. You can also get this information by visiting Medicare.gov. I’ve got Medicaid (page 11) Medicare pays first, and Medicaid pays second. I’m 65 or older and have group health plan coverage based on my own current employment status or the current employment status of my spouse (pages 11–13). • If the employer has 20 or more employees, then the group health plan pays first, and Medicare pays second. • If the employer has less than 20 employees and isn’t part of a multi-employer or multiple employer group health plan (see page 18), then Medicare pays first Here is the link that explains who pays first in detail: https://www.medicare.gov/Pubs/...n-benefits-payer.pdf | |||
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Member |
This is correct. This is one of the biggest problems I ran into when I was working at SSA. If you don't sign up during your initial enrollment period, you better be sure that either: 1. you don't need it - 0R - 2. you will be able to enroll during a special enrollment period when you retire. | |||
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Thank you Fed161! | |||
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Member |
If you have a doctor you like, you might have to consider paying out of pocket for you medical exams and use medicare for your labs. That's what we found in our rural area. Doctors here do not want to deal with the added costs to deal with medicare. The only doctors that take medicare patients here are associated with the regional hospital and there's not many of them. Getting appointments and followup from tests was beyond frustrating. It's not feasible to drive 100+ miles to metro Phoenix. We got tired of it and decided to pay out of pocket to keep our small practice doctor who refused to accept medicare. Then a medicare accepting conglomerate bought out her practice. | |||
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Member |
I just have part A. Stayed on my wife's insurance for part B. Her employer changed providers January 1. Hope I chose wisely. _____________________ Be careful what you tolerate. You are teaching people how to treat you. | |||
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Member |
When your wife retires (I'm assuming she is working) your special enrollment period for part B begins. It's your only chance to enroll in part B without a permanent life time penalty (if you decide to enroll later). Just be aware of that. You will be fine as long as you keep that in mind. In your case not taking part B makes sense. | |||
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I have not yet begun to procrastinate |
^^This^^ I’m not old enough yet but I am retired. The Public Safety Retirement System that covers me and my older friends wanted them signed up ASAP when that magic birthday hits. (They worked side jobs that paid into SS, I just worked OT shifts for the Fire Dept) I have no idea how this will affect me yet, I haven’t paid anything to SSA for my whole 31 yr career. The last time I paid anything was 1 quarter in 1985. I don’t know if that affects eligibility or not. -------- After the game, the King and the pawn go into the same box. | |||
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As Extraordinary as Everyone Else |
I want to thank all who,have contributed to this discussion particularly Fed161. I turned 64 last month so this is one of my big projects for this year. Like others I am retired but on my wife’s insurance policy for the next 5 years or so, so this discussion is timely. Thank you. ------------------ Eddie Our Founding Fathers were men who understood that the right thing is not necessarily the written thing. -kkina | |||
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Admin/Odd Duck |
I have been on Medicare since May of last year. If you are turning 65, you don't need to wait for the standard enrollment dates in November and December each year. You sign up anytime in the 60 days prior to your birthday when you are turning 65. I have A and B as well as a part D RX plan and a supplemental plan to help cover what Medicare doesn't. It's not really complicated and so far so good. Be aware if picking up Part B, the premium is on a sliding scale of income. I pay the max premium which is about $580 per month. I have a lot of income. I am saving about 2 thousand dollars a month from my old private healthcare plan since cancelled. Medicare is covering all my cancer care bills so far. ____________________________________________________ New and improved super concentrated me: Proud rebel, heretic, and Oneness Apostolic Pentecostal. There is iron in my words of death for all to see. So there is iron in my words of life. | |||
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Member |
Before my wife and I retired - on the same day. We found a knowledgeable person at our Council on Aging. She spent about 2 hours with us going over parts A, B, C, D and the various supplements available. She confirmed our earlier decision as to which supplement we wanted. From that point it was a simple matter of contacting our insurance guy and signing up. Incidentally, we have part G. I'm sorry if I hurt you feelings when I called you stupid - I thought you already knew - Unknown ................................... When you have no future, you live in the past. " Sycamore Row" by John Grisham | |||
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Legalize the Constitution |
I am retired, but my wife is 10 years younger than I. I signed up for Medicare and Part B. I have the ability to keep paying for BCBS, especially to cover my wife who is not eligible for Medicare and won’t be for several more years. Medicare automatically becomes primary, and BCBS secondary. Thus far, it has worked out great for both of us. My wife continues to have insurance and with the combination, I have nothing out of pocket—no co-pays, nothing. This summer, I had a major surgical procedure, between the two (Medicare and Blue Cross), I owe nothing. That surgery alone made the expense of carrying the BCBS for my wife, a real benefit for me. _______________________________________________________ despite them | |||
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Member |
https://www.medicare.gov/suppl...with-other-insurance "How Medicare coordinates with other coverage If your questions about who pays first, or if your coverage changes, call the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627" | |||
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california tumbles into the sea |
lots of great info here. thanks. | |||
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Member |
One more thing to consider... Medicare would be secondary ins for part b if your employer has over 100 employees, and you were working and carried your main plan. If less than 100 employees, it would become primary if you signed up for part b benefits. I have seen at least one instance, where the person did not sign up for part b, so his main ins was the only one for dr visits, and they penalized him for not signing up. The reasoning was, they would be secondary, if he had part b, so they would only pay as if they were secondary. Hopefully, you don’t have this issue. | |||
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Member |
I signed up for Medicare when I turned 65 but remained on my employers plan at that time. I'm 67 now (waiting for my first social security check this week or next). Although I have Part A, my wife is ~10 yrs younger than me and I'm on her benefits plan. Unless her employer forces me to drop off her plan, I'll stay on hers. | |||
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