I went on Social Security 2 years ago due to muscular dystrophy. I'm 46. Now I am eligible for Medicare. I have private insurance (Blue Care Network HMO) through my wife's employment.

Questions:

Why would I pay the premium for Medicare Part B if I have private health insurance? I'd rather opt out.

Am I REQUIRED to purchase Medicare Part B? Can Blue Care Network FORCE me to purchase Medicare Part B as my primary insurance (to get themselves off the hook).

Anyone else in this situation?

Mark

My husband was in the same boat. He receives full coverage from my employment. My benefits coordinator says that they recommend that he only opt for Part A (the free part) until he reaches retirement age.

Part A is currently covering his inpatient costs for a total knee replacement and I guess the benefits are coordinated. I'm very curious to see how much he'll have to pay of the total bill. We're still paying for his back surgery from two years ago but that was before he qualified for Medicare.

You are not required to buy additional coverage through SSDI. Your wife's insurance will be primary, Med A will be secondary. I've never heard of an insurance company requiring you to purchase SSDI's additional coverage. You will have to let the SSA know your intentions, though, if you haven't already mailed in your choice.

Thanks kaybee,

I was hoping to opt out of part B. I couldn't see paying $90/month when my wife's employer is already paying a Blue Cross premium.

I've not yet returned my choice to SSI/Medicare but I have to soon. Also, Medicare just sent me a questionnaire about any additional insurance I might have. I assume that by revealing my HMO to them that it will not affect anything. They just want to know if they'll be dealing with another insurance company should I be hospitalized. Does this sound right?

Thanks again!

That's right. As long as you have inpatient coverage (Med A) you should be fine. Your wife's insurance will always be primary so the SSA needs to know that. I'll let you know how much Med A picks up when the bills start coming in - if you're interested.

Thanks so much for your help kaybee. I'll check back from time to time.

Mark

Before you make any kind of decision, please double check with your spouses insurer as to whether or not they are actually considered primary. I'm quite certain that her employer will only be considered primary if they have 100 employees or greater.
If her employer is primary, part B would basically be duplicate coverage and most likely be of no value to you.

If her employer is not considered primary, you will most likely need to opt into part B then her coverage would pick up the 20% that Medicare doesn't pay.

Before you make any kind of decision, please double check with your spouses insurer as to whether or not they are actually considered primary. I'm quite certain that her employer will only be considered primary if they have 100 employees or greater.
If her employer is primary, part B would basically be duplicate coverage and most likely be of no value to you.

If her employer is not considered primary, you will most likely need to opt into part B then her coverage would pick up the 20% that Medicare doesn't pay.

Thanks for the advice. I will check with her insurance company to verify this before I make my decision. Her company is borderline 100 people so I'm glad you mentioned it.

Hope your back gets better,
Mark

You are very welcome, I hope you feel better as well.

Please let us know how you make out if you get a chance.

I have been on SSD for about four years. I turned down Medicare Part B, due to my wife's insurance at her work. I am covered on that (Blue Cross) and it's a lot less than Medicare.

My wife will be retiring at the end of next year. Her HR people have told her I would go to Medicare Part B as my primary and Blue Cross would become my secondary. The employer has approximately 4,000 people.

Does this sound right? I did take the Part A of course, which is free.

I can't say for certain, but what the HR people told your wife may very well be correct.

I'm quite sure that I read somewhere that the coordination of benefits (COB) for retirees are often handled differently than they are for active employees.
Now that I think of it, I think the booklet that Medicare sends out (and is also available for online viewing at the Medicare website) called Medicare & You 2007, may be where I read about COB's for retirees when they retain benefits after retirement.

I'm glad you brought up the topic, as I'm also currently covered under my spouses insurance and didn't have to opt into part B, I now wonder if the same will apply to me in the future.

I'm not sure if your wife is in a union as my spouse is, but I do know that some unions have specific rules regarding retirees and COB. If she is covered in a union, her union contract will most likely cover the topic as well.

Please keep us posted if you find out differently.

Thanks for the advice and input everyone.

YES ! I have VERIFIED this on the Medicare website.....In Medicare's FAQ section I found a paragraph stating "If you have Group health insurance either through your employment or a spouse's employment, and that company has MORE than 100 employees, then the Group health plan is your primary insurance and Part B would be of little value to you".

Exceptions are:
Less than 100 employees.
You are 65+.
The insured retires.
In these cases Medicare Part B becomes your primary insurance.

So...I have opted out of Part B and will save $93 / month.

Thanks again,
Mark

Great news Mark :) I'm so glad it all worked out for you just as it did in my case. Thanks so much for keeping us posted.

I was pretty sure that's where I read the info when I was researching the issue for myself.

I'm glad you posted that part from the Medicare site as that must be where I read about retirees benefits being handled differently as in Director's case.

I hope you all have a good weekend.

My thanks too, Mark. So I'm doing things right as far as not taking part in the Part B of Medicare. When my wife retires at age 62, I will change over and pick up Part B as my primary and Blue Cross will be my secondary. BTW, my wife is not a union worker.

Does anyone know what the open enrollment dates are to sign up for Part B? Maybe there aren't any specific dates if you already have Part A. I would like to coordinate it with my wife's retirement date as closely as I can.

Medicare offers a special enrollment period for beneficiaries who are covered under employer sponsored health insurance.

Below is what I found under one of the Medicare sites:

"Beneficiaries who delay enrolling in Part B because they are covered by employer-sponsored health insurance as an active worker or as a dependent of an active worker are not limited to enrolling in Part B during the GEP. They have an SEP that runs for eight months from the time they (or their spouse) retire or they lose their health insurance. Part B coverage starts the month after the election is made, and no late premium penalty is assessed."

Here is the link where I found the info, the site also details other Medicare enrollment periods.

http://www.medicareadvocacy.org/Medicare_EnrollmentPeriods.htm

Medicare offers a special enrollment period for beneficiaries who are covered under employer sponsored health insurance.

Below is what I found under one of the Medicare sites:

"Beneficiaries who delay enrolling in Part B because they are covered by employer-sponsored health insurance as an active worker or as a dependent of an active worker are not limited to enrolling in Part B during the GEP. They have an SEP that runs for eight months from the time they (or their spouse) retire or they lose their health insurance. Part B coverage starts the month after the election is made, and no late premium penalty is assessed."

Here is the link where I found the info, the site also details other Medicare enrollment periods.

http://www.medicareadvocacy.org/Medicare_EnrollmentPeriods.htm

Thanks MBH.....this is good to know!
Mark

You are welcome, I'm glad to be of help when I can.