Medicare + Group plan

[LostDollar]

Ok, I looked back and see you didn't see anything about Part B, just Medicare.

Keep in mind that I am not an insurance agent and have not had to help myself or anyone else deal with Medicare related hospital claims.

The following is just my personal opinion, but I think that you have to have some facts before you can offer these folks any useful guidance.

Which coverage is primary, group or Medicare.

Have claims been filed with group or with medicare-if so you should see the EOB's. (Original medicare calls them MSN's).

Find out what Medicare he has, ie just Part A or both Part A and Part B.

When you see those things, then you can start thinking about what the next step should be.

 

[goillini52]

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

We come here for learning, sharing, teaching, trolling AND entertainment.

Also, many come here to "pimp" their wares and services.

 

[goillini52]

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

He should check with HR where he works and ask these questions that have come up in the thread. Until you find these things out, all you can do is speculate.

 

[vic120]

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

He contributes more than many, But he jokes too, Nothing wrong with having some fun

 

[vic120]

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

It wouldn't be the first time I have heard that someone got part B in this situation because of either

They thought they had too,

Had heard there was a penalty if they do not sign

or just wanted extra cover without looking into how the plans do or do not work together

 

[somarco]

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

Medicare is secondary to group with 20+ employees. I have no idea where the other poster got 50 lives. Typo maybe?

Medicare almost never pays anything as a secondary payer.

https://www.medicare.gov/Pubs/pdf/02179-medicare-coordination-benefits-payer.pdf

 

[New kid]

thank you