Medicare + Group plan

[New kid]

Hello everyone,
Client called me saying he has $5k bill from 3 day hospital stay. He has Medicare and Group plan through his work and my assumption is that hospital did not bill Medicare. Question is: if Group plan pays first and Medicare second, does my client still have to pay 1364$ deductible or medicare will cover everything group plan didn't cover?
Thank you

 

[Chazm]

It’s quite possible that he should of delayed part b because it’s not paying anything.

 

[SandraNT]

If his Group is 50 Employees and over it will never go to Medicare. Group has an Out of Pocket Maximum whereby the Insurance kicks in 100% when that is met.
Medicare will never be AND should not be billed.
The $5k bill is bases on Group Copays/CoInsurance, look at the Bill and get Summary of Benefits to check the rules.

 

[New kid]

In that case, why he has medicare? I thought Medicare is secondary (with group plan) for companies over 20 employees and primary for small business

 

[LostDollar]

Hello everyone,
Client called me saying he has $5k bill from 3 day hospital stay. He has Medicare and Group plan through his work and my assumption is that hospital did not bill Medicare. Question is: if Group plan pays first and Medicare second, does my client still have to pay 1364$ deductible or medicare will cover everything group plan didn't cover?
Thank you

(Caveat, not an insurance agent.)

Do you know, as a fact, that his group plan is primary to his medicare coverage?

 

[New kid]

No, wife called while husband was at work. I have to speak with them later today

 

[LostDollar]

In that case, why he has medicare? I thought Medicare is secondary (with group plan) for companies over 20 employees and primary for small business

Posts and threads on the site indicate that, unfortunately, not everyone makes informed decisions about when to take Part B.

 

[New kid]

LostDollar, what do you mean? I am a new agent

 

[goillini52]

LostDollar, what do you mean? I am a new agent

So is he.

Sorry LD.....couldn't help myself. You still should make the jump.

 

[New kid]

goillini58, you should contribute instead of joking
is this forum a place where we come and learn new stuff or what?