Medicare As a Secondary

[axeman462]

Have only come across this scenario a few times before. Not really sure how it works.

If someone has insurance through an employer, and their insurance acts as the primary. The company says she dont have to pick up Pt B, but she wants to anyway, so Medicare acts as a secondary. Will Medicare pick up deductibles and copays? Or would she still have to pay Medicare deductibles first, before Medicare acts as a supplement?

 

[unic.consulting]

Have only come across this scenario a few times before. Not really sure how it works.

If someone has insurance through an employer, and their insurance acts as the primary. The company says she dont have to pick up Pt B, but she wants to anyway, so Medicare acts as a secondary. Will Medicare pick up deductibles and copays? Or would she still have to pay Medicare deductibles first, before Medicare acts as a supplement?

With Medicare secondary, it doesn't have the same deductible/coinsurance structure. There are still some instances where she may have to pay some money, but most of the time I have found Medicare will pick up the copay/deductible from the main insurance.

 

[somarco]

I would be very surprised if Medicare paid anything as a secondary payer to an employer group plan.

Typically Medicare reimbursement is much less than what a group plan pays.



The insurance that pays first (primary payer) pays up to the limits of its coverage.

The one that pays second (secondary payer) only pays if there are costs the primary insurer didn't cover.

https://www.medicare.gov/supplement.../how-medicare-works-with-other-insurance.html

If the employer plan pays nothing, because the deductible is greater than $166, Medicare will most likely pay nothing.

If the employer plan pays something, Medicare will likely pay nothing because the group reimbursement is higher than the Medicare allowance.

 

[DS4]

You are usually better of to waive Part B and save the $121.80/month.

 

[steveadlman]

You are usually better of to waive Part B and save the $121.80/month.

If she takes her Part B now when she retires and comes off of her group health plan she will get a GI to enroll in a Medicare Supplement but not Open Enrollment. Plans G and N are not offered under GI. I agree paying the Part B premium is a waste of money.

 

[yogooglethis]

Have only come across this scenario a few times before. Not really sure how it works.

If someone has insurance through an employer, and their insurance acts as the primary. The company says she dont have to pick up Pt B, but she wants to anyway, so Medicare acts as a secondary. Will Medicare pick up deductibles and copays? Or would she still have to pay Medicare deductibles first, before Medicare acts as a supplement?

Depends of what EGHP they have.I have seen cases such as the local school board were working medicare eligible people pick up part B then pay less or nothing of pocket .Also if they enroll in MA the local school board coordinates with MA and they pay nothing out of pocket.With that said IMO its almost always a waste of money for working eligible s to enroll it part B unless of course they can get a better deal in the individual medicare health plan market- which is becoming more common.