Secondary Insurance

[IwannabeinNarnia]

My husband is now on Medicare.. he is also on my insurance. His aunt has told him to keep both. But with money tight I really don't want to keep paying for him to be covered on mine also if it's not necessary. Is secondary insurance useful or not? Is it worth paying out the money for him to have both?

[Itchy]

I am not totally sure of the answer but I can relate to my ex-boss, he had the insurance that the city we worked for and no medicare even though he was over 65. If I understood him correctly when I asked him about it he told me that he had to show social security that he was covered. He was not required to get medicare until he retired.

Having said that I would go to the social security web site and look or an answer or call your local office. I could be wrong but once you have it I think you need to keep it.

Hope this helps...:mickey:

[Hammer]

Personally, I would do what I can to keep him covered under your insurance as well as Medicare. My Mom has insurance which covers her(and my Dad as well when he was alive) ithrough her retirement benefits. She also got Medicare at 65 and it becomes your primary insurance. However, for things that Medicare does not fully cover, a doctor/hospital/lab sends the bill to the secondary insurance. This way, my Mom is not surprised with a bill which she would have to pay the difference. This was especially helpful when my father was diagnosed with cancer, eventually passing away from the disease, as everything was covered for all of his procedures.

[DizneyRox]

Only you can answer that question... Used to be people would have two policies and the secondary would pay for whatever the primary didn't. This was referred to as coordination of benefits. They would coordinate to pay up to the octal amount of the covered expenses.

Since then, to save money, they offer maintenance of benefits plans. The secondary usually makes sure you are reimbursed up to what they would cover. So, if both cover say 80% of a $100 charge, if the primary pays $80, the second pays nothing. If the primary only paid $70, the secondary would pay $10.

Medicare throws a whole other complexity into the mix. Part A, Part B, Medicaid, it gets pretty confusing. It's been a while, I used to be a CSR for a health insurance company.

I would say though, it's probably not too beneficial to keep a secondary plan. I know insurance ain't cheap these days, employers are paying less and less putting more of the cost share onto the employees and if they are a maintenance of benefits type plan, you may not see any reimbursement from them.

You need to run the numbers though...

[vicster]

If Medicare is the primary (not always the case) the secondary insurance would be cheaper and probably worth it.

[IwannabeinNarnia]

Medicare is his primary now... we were trying to make it secondary but they won't allow us.. now they are going back a whole year to when he got Medicare and are rebilling everything.. we keep getting bills for thousands of dollars from the doctors and such.. and he's having to call to make sure they are sending them thru to medicare.. it's been a hassle. I believe he has Plan A and B... it's all so confusing and just not sure keeping him on mine is worth it.

[Hammer]

Medicare is his primary now... we were trying to make it secondary but they won't allow us.. now they are going back a whole year to when he got Medicare and are rebilling everything.. we keep getting bills for thousands of dollars from the doctors and such.. and he's having to call to make sure they are sending them thru to medicare.. it's been a hassle. I believe he has Plan A and B... it's all so confusing and just not sure keeping him on mine is worth it.

This happened to my Mom when she qualified for Medicare and her other insurance became her secondary insurance ( I agree, you should be able to make Medicare secondary if you have primary insurance). You just have to take a deep breath and call all of his doctors to tell them that Medicare is now his primary and should get the bills first. Then the doctors' offices should send the bill to the secondary insurance after they receive payment from Medicare for the difference. It will take a couple of times before some doctors' get their records straight, you just have to have patience. If any of your doctors are not helpful, I personally would find a new doctor That's what my Mom did for one of her specialists. Part of this process is speaking up and being your own advocate.

Again, I think it is better to have the secondary insurance if there is a medication or procedure a doctor wants to perform and Medicare does not cover all of it, you have another avenue rather to cover costs.

[vicster]

You cannot dictate whether Medicare is primary. It's based on the number of employees where you work

[Hammer]

You cannot dictate whether Medicare is primary. It's based on the number of employees where you work

True, but that doesn't mean they couldn't change the rules at some point :), as it is a government program.

[vicster]

True, but that doesn't mean they couldn't change the rules at some point :), as it is a government program.

Good point!!

[TheDuckRocks]

If you are able to I would go down to your local Social Security office and talk to them. Every case is somewhat different.
My DH is 73 and still works. I'm 69 and have retired.
Our Medicaid A (the part that covers hopitals, etc.) we get at no charge to us and for the covered items is the primary insurance, with emplorer's insurance secondary. After both of these kick in we never have anything we have to pay.
The part B ( doctors visits, etc.) we do not have at this time, so we do not pay anything for it out of pocket and employer's insurance is primary for these items with no secondary. Through our insurance we have a set co-pay amount.
When my DH retires we will have 18 months in which to start the part B through Medicaid and they will deduct it from our SS income.
Hope this gives you idea of another way that might be a solution for you.
Go see them. I would never have gotten the whole thing straightened out with a phone call.