I have BlueShield Medical insurance. My copay is $15. My company takes care of it. I also have hospitalization for me and my spouse..
Total Comments: 95
Posted: Sun Apr 11, 2010 07:24 pm Post Subject: medicare and group health
thank you folks you were really a big help to me after i'd looked at countless web pages this is where i got my answers. Well done!
Posted: Fri Apr 16, 2010 02:17 am Post Subject:
What determines whether medicare will be primary or secondary?
Medicare Part A is "automatic" at age 65, and there is no cost for a "fully-insured" beneficiary -- one who has obtained the required 40 Social Security "credits" (no longer called "quarters") before reaching age 65. Others who are not "fully-insured" pay a premium for Part A.
Part A covers the costs associated with hospitalization (inpatient services only, no doctor bills!). Part B (covers doctor bills, outpatient hospital expenses -- ER & diagnostics -- and certain other "medically-necessary" expenses such as durable medical equipment, transportation, etc.) is optional, and may be rejected at age 65, but everyone pays a premium for Part B. Rejecting Part B and/or Part D at age 65 could result in a 10% per year cumulative premium penalty when enrolling later in Part B, and a 1% per month penalty for not enrolling in a Part D plan at age 65.
However, a Medicare beneficiary still working at age 65 (there are lots of them these days, and there will be more in the future) and covered by an employer-sponsored health plan has the choice of whether to keep his employer's group health plan or not, and if they choose to keep it, whether to make it primary or secondary to Medicare.
Keeping the employer-sponsored plan primary might allow the employee to opt out of Medicare Part B (and Part D, if there is also prescription drug coverage). If so, there would be an eight month "special enrollment period" for Parts B & D if the beneficiary later drops or is no longer covered by the employer-sponsored plan, and the premium penalties would not apply.
But the employer will be required to pay a hugely inflated premium for any Medicare beneficiary that chooses to keep the group insurance and make it primary to Medicare -- as much as triple the standard group rate -- which may be passed on to the employee, an incentive to get the employee to make the group plan secondary to Medicare if they choose to keep it.
The reason is that the group plan (probably) provides substantially better benefits than Medicare Parts A & B, and D.
So why keep the employer-sponsored plan but make it secondary? Simple, use Medicare when the service is covered, mostly taking the employer plan off the hook, and use the employer plan only when Medicare doesn't cover a procedure or some or all of the cost of care.
Properly coordinated, an employer-sponsored plan secondary to Medicare will often result in very little out of pocket expense.
But the rub may also be that to keep the employer-sponsored plan as secondary, the insurer may require that the employee enroll in Medicare Part B, for which there is a monthly premium. Paying a premium for both Medicare Part B and the group plan may be a financial burden.
If the employee drops the group plan and accepts Medicare, this is a qualifying event under COBRA and his/her qualified dependents under age 65 could elect to continue the group plan, albeit by paying 100% of the cost, for up to 36 months.
Posted: Tue Jul 20, 2010 11:37 pm Post Subject: medicare
Iam turnig 65 have my own company, still working, I pay my own insurance. Medicare with supplementials is $10.00 higher then my current insurance. I don't collect SSN - why do I need medicare
Posted: Wed Jul 21, 2010 03:05 am Post Subject:
When you say "Medicare with supplementals" are you talking about a Medicare Supplement insurance plan? In what part of the country do you live?
Depending on where in the country you live, there may be one or more Medicare Advantage HMO or PPO plans you could enroll in. Where there is sufficient competition among carriers, there may be a low -- or even no -- premium in addition to your Medicare Part B premium, which will be about $111. Even if the Medicare Advantage plan premium was $150 (most are well below that), your total premium between the two would only be about $250 per month . . . probably less than what your premium is for your medical insurance today.
However, as long as you continue your current medical coverage (assuming you can after turning age 65), you are not required to enroll in Medicare Part B -- but that means having to officially "opt out" by completing the form that Social Security will send you. Medicare Part A is automatic and premium-free for all persons beginning at age 65 if "fully insured" (or their spouse is "fully insured") for Social Security retirement benefits, whether you start collecting them at age 66 or not. You can delay commencement of your Social Security retirement benefit to age 70, and will receive a higher monthly benefit for doing so.
After age 65, if you drop your medical insurance (or it terminates you due to age), you will have 8 months to enroll in Medicare Part B and begin paying premiums for it without a penalty. But there is a 10% premium penalty for every 12 months after age 65 that you are not enrolled in a group/private health insurance plan and not enrolled in Medicare Part B.
The penalty is both cumulative and lifetime. Go two years prior to being enrolled in Medicare Part B and without "creditable coverage" in a personal/group health plan, and you will pay the current Part B premium + 20% of that amount. As Part B premiums go up, so will your 20% penalty amount.
If your medical insurance plan does not have a prescription drug benefit, you will need to enroll in a Medicare Part D prescription drug plan (PDP) -- there are no new Medicare Supplement insurance plans being sold which include prescription drug benefits. Failure to enroll in a Part D PDP will invite a 1% lifetime premium penalty for EACH MONTH you do not have "creditable coverage".
So make sure you fully understand what you may do, what you must do, and what you should not do in order to avoid lapses in coverage or premium penalties for the rest of your life.
You can email or PM me with any additional questions.
Posted: Tue Jul 27, 2010 08:01 am Post Subject:
Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities and those who have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease). The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
Medicare is financed by a portion of the payroll taxes paid by workers and their employers. It also is financed in part by monthly premiums deducted from Social Security checks.
The Centers for Medicare & Medicaid Services is the agency in charge of the Medicare program. But you apply for Medicare at Social Security, and we can give you general information about the Medicare program.
(Promotional links removed as per TOU)
Posted: Tue Dec 07, 2010 02:46 pm Post Subject: MEDICARE
MY HUSBAND IS 13 YEARS YOUNGER THEN ME,AND IS STILL WORKING..I HAVE FULL HEALTH INS. BL CROSS BLUE SHIELD THRU THE TEAMSTERS UNDER HIS INS....DO I NEED TO GET PART D EVEN THO I'M COVERED ALMOST 100% FOR MY MEDS THRU HIS INS.?MY PROBLEM IS I DO NOT WANT THE GOVERMENT DIPPING INTO MY SOCIAL SECURITY FOR PAYMENTS,AS I DO NOT GET MUCH..
Posted: Tue Dec 07, 2010 05:03 pm Post Subject:
MY PROBLEM IS I DO NOT WANT THE GOVERMENT DIPPING INTO MY SOCIAL SECURITY FOR PAYMENTS,AS I DO NOT GET MUCH..
What exactly do you mean by this? "The Government" doesn't dip into your Social Security except for Part B premiums. If you are still covered by group insurance through your spouse, at this time you do not need to enroll in Medicare Part B.
If your spouse's group health insurance includes a prescription drug benefit that meets the minimum requirements for "creditable coverage" under Medicare rules, you also may opt out of Part D. You will receive a statement of "creditable coverage" if and when you are no longer covered by the group plan.
When that happens, you will have a "Special Enrollment Period" of 8 months to enroll in Medicare Part B without a penalty, but you must enroll in a Medicare Part D prescription drug plan as soon as possible to avoid the 1% per month penalty for every month you do not have creditable coverage. The cost of a Part D "PDP" is entirely your own out of pocket expense . . . it is not paid for by the Government or deducted from your monthly retirement benefit.
On the other hand, if you enroll in Medicare Part B at this point, Medicare will generally be secondary to the coverage provided by the group health plan.
Posted: Thu Dec 09, 2010 03:25 pm Post Subject:
if you can still avail for medicare then grab the opportunity. it will be beneficial for future use.
Posted: Mon Dec 13, 2010 04:53 pm Post Subject:
if you can still avail for medicare then grab the opportunity.
Personal (or group) medical insurance is far more beneficial than Medicare. Even Medicare Advantage (aka "Part C") is generally more beneficial than "Original Medicare" (Parts A & B).
Mostly, Medicare is a $75,000,000,000,000 UNFUNDED LIABILITY looming in the future for untold millions of grandchildren and great-grandchildren of us Baby Boomers. At least that's what the Trustees are saying would be required in the Trust Fund by 2080 to assure the continuation of the program at the 2006 levels beyond the "infinite horizon."
One problem. There is not that much money in the United States. Sure, we could print it, and then toilet paper would be worth its weight in gold or some other substance, because at that point the currency would be worth S***!
Posted: Sat Dec 18, 2010 12:48 am Post Subject: Opt Out Of Medicare Part B
I am retired from the City , with very good insurance with the City that does not pay S.S. , but I am covered with S.S. other work. I have a letter from the City stating I have incrediable coverage, also prescription drugs. As long as I have this can I opt out of Medicare? and later if I want to go on Medicare will ,I have to pay a penalty.
Garry
Posted: Sun Apr 11, 2010 07:24 pm Post Subject: medicare and group health
thank you folks you were really a big help to me after i'd looked at countless web pages this is where i got my answers. Well done!
Posted: Fri Apr 16, 2010 02:17 am Post Subject:
What determines whether medicare will be primary or secondary?
Medicare Part A is "automatic" at age 65, and there is no cost for a "fully-insured" beneficiary -- one who has obtained the required 40 Social Security "credits" (no longer called "quarters") before reaching age 65. Others who are not "fully-insured" pay a premium for Part A.
Part A covers the costs associated with hospitalization (inpatient services only, no doctor bills!). Part B (covers doctor bills, outpatient hospital expenses -- ER & diagnostics -- and certain other "medically-necessary" expenses such as durable medical equipment, transportation, etc.) is optional, and may be rejected at age 65, but everyone pays a premium for Part B. Rejecting Part B and/or Part D at age 65 could result in a 10% per year cumulative premium penalty when enrolling later in Part B, and a 1% per month penalty for not enrolling in a Part D plan at age 65.
However, a Medicare beneficiary still working at age 65 (there are lots of them these days, and there will be more in the future) and covered by an employer-sponsored health plan has the choice of whether to keep his employer's group health plan or not, and if they choose to keep it, whether to make it primary or secondary to Medicare.
Keeping the employer-sponsored plan primary might allow the employee to opt out of Medicare Part B (and Part D, if there is also prescription drug coverage). If so, there would be an eight month "special enrollment period" for Parts B & D if the beneficiary later drops or is no longer covered by the employer-sponsored plan, and the premium penalties would not apply.
But the employer will be required to pay a hugely inflated premium for any Medicare beneficiary that chooses to keep the group insurance and make it primary to Medicare -- as much as triple the standard group rate -- which may be passed on to the employee, an incentive to get the employee to make the group plan secondary to Medicare if they choose to keep it.
The reason is that the group plan (probably) provides substantially better benefits than Medicare Parts A & B, and D.
So why keep the employer-sponsored plan but make it secondary? Simple, use Medicare when the service is covered, mostly taking the employer plan off the hook, and use the employer plan only when Medicare doesn't cover a procedure or some or all of the cost of care.
Properly coordinated, an employer-sponsored plan secondary to Medicare will often result in very little out of pocket expense.
But the rub may also be that to keep the employer-sponsored plan as secondary, the insurer may require that the employee enroll in Medicare Part B, for which there is a monthly premium. Paying a premium for both Medicare Part B and the group plan may be a financial burden.
If the employee drops the group plan and accepts Medicare, this is a qualifying event under COBRA and his/her qualified dependents under age 65 could elect to continue the group plan, albeit by paying 100% of the cost, for up to 36 months.
Posted: Tue Jul 20, 2010 11:37 pm Post Subject: medicare
Iam turnig 65 have my own company, still working, I pay my own insurance. Medicare with supplementials is $10.00 higher then my current insurance. I don't collect SSN - why do I need medicare
Posted: Wed Jul 21, 2010 03:05 am Post Subject:
When you say "Medicare with supplementals" are you talking about a Medicare Supplement insurance plan? In what part of the country do you live?
Depending on where in the country you live, there may be one or more Medicare Advantage HMO or PPO plans you could enroll in. Where there is sufficient competition among carriers, there may be a low -- or even no -- premium in addition to your Medicare Part B premium, which will be about $111. Even if the Medicare Advantage plan premium was $150 (most are well below that), your total premium between the two would only be about $250 per month . . . probably less than what your premium is for your medical insurance today.
However, as long as you continue your current medical coverage (assuming you can after turning age 65), you are not required to enroll in Medicare Part B -- but that means having to officially "opt out" by completing the form that Social Security will send you. Medicare Part A is automatic and premium-free for all persons beginning at age 65 if "fully insured" (or their spouse is "fully insured") for Social Security retirement benefits, whether you start collecting them at age 66 or not. You can delay commencement of your Social Security retirement benefit to age 70, and will receive a higher monthly benefit for doing so.
After age 65, if you drop your medical insurance (or it terminates you due to age), you will have 8 months to enroll in Medicare Part B and begin paying premiums for it without a penalty. But there is a 10% premium penalty for every 12 months after age 65 that you are not enrolled in a group/private health insurance plan and not enrolled in Medicare Part B.
The penalty is both cumulative and lifetime. Go two years prior to being enrolled in Medicare Part B and without "creditable coverage" in a personal/group health plan, and you will pay the current Part B premium + 20% of that amount. As Part B premiums go up, so will your 20% penalty amount.
If your medical insurance plan does not have a prescription drug benefit, you will need to enroll in a Medicare Part D prescription drug plan (PDP) -- there are no new Medicare Supplement insurance plans being sold which include prescription drug benefits. Failure to enroll in a Part D PDP will invite a 1% lifetime premium penalty for EACH MONTH you do not have "creditable coverage".
So make sure you fully understand what you may do, what you must do, and what you should not do in order to avoid lapses in coverage or premium penalties for the rest of your life.
You can email or PM me with any additional questions.
Posted: Tue Jul 27, 2010 08:01 am Post Subject:
Medicare is our country’s health insurance program for people age 65 or older. Certain people younger than age 65 can qualify for Medicare, too, including those who have disabilities and those who have permanent kidney failure or amyotrophic lateral sclerosis (Lou Gehrig’s disease). The program helps with the cost of health care, but it does not cover all medical expenses or the cost of most long-term care.
Medicare is financed by a portion of the payroll taxes paid by workers and their employers. It also is financed in part by monthly premiums deducted from Social Security checks.
The Centers for Medicare & Medicaid Services is the agency in charge of the Medicare program. But you apply for Medicare at Social Security, and we can give you general information about the Medicare program.
(Promotional links removed as per TOU)
Posted: Tue Dec 07, 2010 02:46 pm Post Subject: MEDICARE
MY HUSBAND IS 13 YEARS YOUNGER THEN ME,AND IS STILL WORKING..I HAVE FULL HEALTH INS. BL CROSS BLUE SHIELD THRU THE TEAMSTERS UNDER HIS INS....DO I NEED TO GET PART D EVEN THO I'M COVERED ALMOST 100% FOR MY MEDS THRU HIS INS.?MY PROBLEM IS I DO NOT WANT THE GOVERMENT DIPPING INTO MY SOCIAL SECURITY FOR PAYMENTS,AS I DO NOT GET MUCH..
Posted: Tue Dec 07, 2010 05:03 pm Post Subject:
MY PROBLEM IS I DO NOT WANT THE GOVERMENT DIPPING INTO MY SOCIAL SECURITY FOR PAYMENTS,AS I DO NOT GET MUCH..
What exactly do you mean by this? "The Government" doesn't dip into your Social Security except for Part B premiums. If you are still covered by group insurance through your spouse, at this time you do not need to enroll in Medicare Part B.
If your spouse's group health insurance includes a prescription drug benefit that meets the minimum requirements for "creditable coverage" under Medicare rules, you also may opt out of Part D. You will receive a statement of "creditable coverage" if and when you are no longer covered by the group plan.
When that happens, you will have a "Special Enrollment Period" of 8 months to enroll in Medicare Part B without a penalty, but you must enroll in a Medicare Part D prescription drug plan as soon as possible to avoid the 1% per month penalty for every month you do not have creditable coverage. The cost of a Part D "PDP" is entirely your own out of pocket expense . . . it is not paid for by the Government or deducted from your monthly retirement benefit.
On the other hand, if you enroll in Medicare Part B at this point, Medicare will generally be secondary to the coverage provided by the group health plan.
Posted: Thu Dec 09, 2010 03:25 pm Post Subject:
if you can still avail for medicare then grab the opportunity. it will be beneficial for future use.
Posted: Mon Dec 13, 2010 04:53 pm Post Subject:
if you can still avail for medicare then grab the opportunity.
Personal (or group) medical insurance is far more beneficial than Medicare. Even Medicare Advantage (aka "Part C") is generally more beneficial than "Original Medicare" (Parts A & B).
Mostly, Medicare is a $75,000,000,000,000 UNFUNDED LIABILITY looming in the future for untold millions of grandchildren and great-grandchildren of us Baby Boomers. At least that's what the Trustees are saying would be required in the Trust Fund by 2080 to assure the continuation of the program at the 2006 levels beyond the "infinite horizon."
One problem. There is not that much money in the United States. Sure, we could print it, and then toilet paper would be worth its weight in gold or some other substance, because at that point the currency would be worth S***!
Posted: Sat Dec 18, 2010 12:48 am Post Subject: Opt Out Of Medicare Part B
I am retired from the City , with very good insurance with the City that does not pay S.S. , but I am covered with S.S. other work. I have a letter from the City stating I have incrediable coverage, also prescription drugs. As long as I have this can I opt out of Medicare? and later if I want to go on Medicare will ,I have to pay a penalty.
Garry
Add your comment