Medicare question


Posted by Delaine Inman , Sep 06,2001,10:10   Archive
SSD says I now have medicare because 2 years have passed. The Hospitalization (part A) is free but the Medical (part B) will be 50.00 a month. I have very good insurance through my husband. When I had insurance through my work, if my primary didn't pay for something(even though it would have been covered if my husbands insurance was primary) his insurance wouldn't pay a dime either. I'm afraid I'll open up a can of worms if Medicare will be considered my primary insurance and it will make my husbands insurance my secondary and I'll have problems getting things covered if Medicare doesn't cover it. Is that clear as Mud???? I'd be interested in feed back and comments and opinions and experiences before I say yes or no to part B. Thanks.



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Re: Medicare question

Re : Medicare question --- Delaine Inman
Posted by Owen Taylor , Sep 06,2001,10:31 Top of Thread Archive
Delaine:
I am an owner of a pretty good sized insurance agency in Sacramento California. While I know little about health insurance Jeff Buchanan, the head of our health insurance department, probably could get you some answers. His number is (800)878-0448. If Jeff can't help I will find an agency in your state.

As a recently diagnosed BEB case our staff is aware of the difficulties it can cause and has been active in getting my insurance carrier to respond properly. Please do not hesitate to call him.

Owen




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Insurance ...

Re : Re: Medicare question --- Owen Taylor
Posted by Moderator-JB , Sep 06,2001,12:23 Top of Thread Archive
Owen:

In another life (pre-Blepharospasm)I was an in-house P/C agent for a finance company and at another time sold health insurance for a short amount of time. (way too long for anyone's health :)

Jduy




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Re: Medicare question

Re : Medicare question --- Delaine Inman
Posted by Moderator-JB , Sep 06,2001,12:17 Top of Thread Archive
Delaine:

Somewhere in that paperwork that you just received from SS & Medicare it states that IF you are covered under another policy you can sign the form and say you do not choose to have Medicare Part B, AT THIS TIME, due to other continuing coverage. You must send that statement back so that if in the future you do need coverage you can sign up for it with no penalty.

Judy




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Re: Medicare question

Re : Re: Medicare question --- Moderator-JB
Posted by Delaine Inman , Sep 06,2001,15:28 Top of Thread Archive
I understood that part. My question is should I turn it down because it might cause problems with my husbands insurance?



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Re: Medicare question

Re : Re: Medicare question --- Delaine Inman
Posted by Moderator-JB , Sep 06,2001,16:58 Top of Thread Archive
Delaine:

Yes, turn it down - you need no more nightmares in your life at this time. It would make the turn around time on payments to your physician a nightmare.

Judy




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Re: Medicare question

Re : Re: Medicare question --- Moderator-JB
Posted by Shirley-Arkansas-USA , Sep 06,2001,17:28 Top of Thread Archive
Judy,
Ok, Let me get this straight since I also will probably be dealing with this within the next 6 months or so.
My plan was to accept part A of Medicare and it be my primary and I would turn down Part B as secondary and use my husbands insurance as secondary. We have never had any problems with my husbands insurance being primary or secondary. They have paid well and without problems when I used them as a secondary insurance.
Have I got this straight or are you telling Delaine to turn down Medicare A and B? Sorry, I just got a little confused with what you thought it best to turn down.

Mud, mud, mud.

Shirley in AR.




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Re: Medicare question

Re : Re: Medicare question --- Shirley-Arkansas-USA
Posted by Moderator-JB , Sep 06,2001,20:57 Top of Thread Archive
Shirley:

Part A is hospitalization primarily. You will automatically get that (no premium). What I'm doing, perhaps kosher or not is to submit claims solely to my husband's insurance carrier and not use the Part A at this time though it does exist.

Don't quote me on this one.

Judy




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Re: Medicare question

Re : Medicare question --- Delaine Inman
Posted by Sally - in - Idaho , Sep 06,2001,22:56 Top of Thread Archive
Delaine,

I would be extremely careful about turning anything down without thoroughly researching all angles. When I became eligible for Medicare (taking retirement at age 62) I was okay with just Part A until I was 65 because my previous employer was paying my premiums.

At age 65 I became responsible for paying the premiums, although still allowed to be under past employer's group plan forever if I so choose. I was required to take Part B of Medicare (at $50 per month) by my HMO. What happens now is this: Medicare tells the doctors what THEY allow for a certain procedure and the doctor agrees to do it for that amount. Then Medicare pays 80% of what they have deemed allowable, and my HMO picks up the other 20%. I never see bills from any of them, except for a printout from Medicare on the payments to the neurologist for BEB. His fee is approximately $1300, but Medicare only allows $800 or thereabouts, and he has agreed to abide by that. So Medicare pays him 80% of the $800, and HMO pays him the 20% of $800.

Just don't want to have you hanging out to dry by not checking everything out very carefully.

Sally in North Idaho




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Re: Medicare question

Re : Re: Medicare question --- Sally - in - Idaho
Posted by Eileen Morin , Sep 07,2001,14:17 Top of Thread Archive
Delaine: I firmly agree with Sally (No. Idaho) regarding turning anything down without thoroughly researching all your doubts, fears, questions and concerns. I was on disability due to BEB and retired at age 65. My employer opted for poor health plans for retirees (some would not consider paying for Botox, let alone pay doctor to administer the shots (fees excessive!) Checking all health plans vs. buying direct payment for health insurance (expensive), plus paying for Botox and doctors visits myself, I found I would not have any worries using Medicare as primary (Part B) and the BC/BS Medex Gold plan. Never receiving an invoice with $..00 balance owed. It proved to be the best for me, having Medex Gold also allowed me the best health coverage I could possibly want and thru the years since retirment need. Using Sally's last line of message... Just don't want to have you hanging out to dry by not checking everything out very carefully. GOOD LUCK and by the way many, many thanks for your input on BB board, always search for your name.
Eileen - North of Boston, MA



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  • Re: Medicare question --- Eileen Morin ( Sep 07, 14:32, 2001 )