My sister was jdiagnosed with stage 4 cancer at the age of 48. She was a part time employee with a large company like Sears and had no insurance benefits with them. She is covered under her husbands employer insurance. Should she apply for medicaid coverage or early medicare as secondary in case something happens to his job?
Posted: Wed Sep 26, 2012 07:22 pm Post Subject:
There is no such thing as "early Medicare". A person must be age 65 and have "fully insured" status with Social Security to be eligible for Medicare.
However, if a person is qualified for and has been receiving SS disability benefits for 24 consecutive months, they are automatically admitted to Medicare regardless of age.
You cannot apply for Medicare or Medicaid as "secondary" coverage under the scenario described. Medicaid is a program to pay the healthcare expenses of persons who are known as "medically indigent" -- they do not have health insurance and, based on income and assets, do not have the resources to pay for health insurance or pay for all of their unpaid/ineligible Medicare expenses.
A person age 65 or older who still works (or is the dependent of a worker) and has coverage under an employer-sponsored health insurance plan generally places Medicare in the second-payer position. The exception is a small-employer plan (covering 50 or fewer employees), in which the participant may elect to make the employer's health plan primary (higher premium) or secondary (lower premium), or decline the employer's coverage in favor of Medicare. Medicare is ALWAYS secondary coverage (and generally has no liability) in a workers' compensation claim situation.
Posted: Thu Oct 18, 2012 09:13 pm Post Subject: husband on my insurance coverage
I am 58 and still working..My husband is 64 and is covered on my plan..will I be able to continue to keep him covered on my insurance plan after he turns 65? As a primary plan, or secondary?...I understand he can opt not to take Medicare Part B or D but will pay a penalty if he signs up at a later date.
Posted: Fri Oct 19, 2012 07:10 pm Post Subject:
If your husband can be carried on your employer's plan as a dependent after age 65, and later decides to opt into Medicare Part B and/or Part D, unless he fails to enroll on a timely basis, he will not be penalized. He will have 8 months to enroll in Medicare Part B after terminating from your plan. He must obtain Part D coverage sooner.
The best option is a Medicare Advantage Plan with Prescription Drug coverage. No additional cost beyond the Medicare Part B premium in many places.
Posted: Mon Oct 22, 2012 09:43 pm Post Subject: penalty for part b
my wife is diabled and has medicare part a refused part b in 2009 because she was covered by my insurance at fedex i hade a heart attack in november 2010 and on LTD and we still have full insurance with fedex if she wants part b is there still a penalty
Posted: Tue Oct 23, 2012 11:51 am Post Subject:
No. Her coverage under your employer-sponsored plan exempts her from the premium penalty. She may currently re-enroll in Part B at any time, but must do so within 8 months of termination from your employer-sponsored plan to avoid the penalty in the future.
If you have significant out of pocket expenses with your employer's plan, you might have her consider the alternatives that Medicare Advantage offers. In many areas, there is no additional premium for Medicare Advantage other than the Part B premium (but there are now 3 base premium schedules for Part B, depending on when a person first started paying Part B premiums, as well as the "rich person's" surcharge).
Medicare Advantage HMOs and PPOs are providing better coverage for their subscribers than Medicare Parts A and B ("Original Medicare"), and in major metropolitan areas with younger, healthier populations, many are offering services with very little out of pocket expense, especially for hospitalization (potentially tens of thousands of dollars less than under Original Medicare!).
Medicare Advantage open enrollment is now in effect thru December 7. But your wife would be able to enroll in a Medicare Advantage plan immediately whenever she enrolls in Part B, even if in the middle of the year.
Posted: Tue Nov 06, 2012 08:13 pm Post Subject: Medicaid
Do I continue covering my husband on my medical/dental insurance if he is receiving Medicaid?
Posted: Tue Nov 06, 2012 08:26 pm Post Subject:
Medicaid?
Or do you mean Medicare? How is it that you have employer-sponsored health insurance and your husband is on Medicaid? That's not supposed to happen.
Posted: Wed Nov 14, 2012 07:38 pm Post Subject: Part B Vs Group Insurance
I am on disability and eligible for Medicare. Husband works for the USPS. Our Group policy is a Consumer Driven type plan. I understand that that would be the Primary Policy if I elected Part B. Is there any advantage in having both Group Insurance AND Medicare part B?
Posted: Thu Nov 15, 2012 04:31 am Post Subject:
There is no benefit or need to be on both an employer's group pan and Medicare Part B -- unless the group plan doesn't cover something that Medicare does. But Part B, which only pays for physician's expenses and outpatient hospital expenses, is unlikely to provide a better benefit (a possible exception would be if your physician is not in your group health plan's network -- generally unlikely).
A different consideration is that with enrollment in both Medicare Parts A & B, you can substitute those benefits with a Medicare Advantage plan (HMO/PPO) which could offer you a lower cost alternative. Talk to a local agent offering Medicare Advantage plans to explore your options.
Posted: Wed Sep 26, 2012 01:49 pm Post Subject: medicaid/medicare coverage
My sister was jdiagnosed with stage 4 cancer at the age of 48. She was a part time employee with a large company like Sears and had no insurance benefits with them. She is covered under her husbands employer insurance. Should she apply for medicaid coverage or early medicare as secondary in case something happens to his job?
Posted: Wed Sep 26, 2012 07:22 pm Post Subject:
There is no such thing as "early Medicare". A person must be age 65 and have "fully insured" status with Social Security to be eligible for Medicare.
However, if a person is qualified for and has been receiving SS disability benefits for 24 consecutive months, they are automatically admitted to Medicare regardless of age.
You cannot apply for Medicare or Medicaid as "secondary" coverage under the scenario described. Medicaid is a program to pay the healthcare expenses of persons who are known as "medically indigent" -- they do not have health insurance and, based on income and assets, do not have the resources to pay for health insurance or pay for all of their unpaid/ineligible Medicare expenses.
A person age 65 or older who still works (or is the dependent of a worker) and has coverage under an employer-sponsored health insurance plan generally places Medicare in the second-payer position. The exception is a small-employer plan (covering 50 or fewer employees), in which the participant may elect to make the employer's health plan primary (higher premium) or secondary (lower premium), or decline the employer's coverage in favor of Medicare. Medicare is ALWAYS secondary coverage (and generally has no liability) in a workers' compensation claim situation.
Posted: Thu Oct 18, 2012 09:13 pm Post Subject: husband on my insurance coverage
I am 58 and still working..My husband is 64 and is covered on my plan..will I be able to continue to keep him covered on my insurance plan after he turns 65? As a primary plan, or secondary?...I understand he can opt not to take Medicare Part B or D but will pay a penalty if he signs up at a later date.
Posted: Fri Oct 19, 2012 07:10 pm Post Subject:
If your husband can be carried on your employer's plan as a dependent after age 65, and later decides to opt into Medicare Part B and/or Part D, unless he fails to enroll on a timely basis, he will not be penalized. He will have 8 months to enroll in Medicare Part B after terminating from your plan. He must obtain Part D coverage sooner.
The best option is a Medicare Advantage Plan with Prescription Drug coverage. No additional cost beyond the Medicare Part B premium in many places.
Posted: Mon Oct 22, 2012 09:43 pm Post Subject: penalty for part b
my wife is diabled and has medicare part a refused part b in 2009 because she was covered by my insurance at fedex i hade a heart attack in november 2010 and on LTD and we still have full insurance with fedex if she wants part b is there still a penalty
Posted: Tue Oct 23, 2012 11:51 am Post Subject:
No. Her coverage under your employer-sponsored plan exempts her from the premium penalty. She may currently re-enroll in Part B at any time, but must do so within 8 months of termination from your employer-sponsored plan to avoid the penalty in the future.
If you have significant out of pocket expenses with your employer's plan, you might have her consider the alternatives that Medicare Advantage offers. In many areas, there is no additional premium for Medicare Advantage other than the Part B premium (but there are now 3 base premium schedules for Part B, depending on when a person first started paying Part B premiums, as well as the "rich person's" surcharge).
Medicare Advantage HMOs and PPOs are providing better coverage for their subscribers than Medicare Parts A and B ("Original Medicare"), and in major metropolitan areas with younger, healthier populations, many are offering services with very little out of pocket expense, especially for hospitalization (potentially tens of thousands of dollars less than under Original Medicare!).
Medicare Advantage open enrollment is now in effect thru December 7. But your wife would be able to enroll in a Medicare Advantage plan immediately whenever she enrolls in Part B, even if in the middle of the year.
Posted: Tue Nov 06, 2012 08:13 pm Post Subject: Medicaid
Do I continue covering my husband on my medical/dental insurance if he is receiving Medicaid?
Posted: Tue Nov 06, 2012 08:26 pm Post Subject:
Medicaid?
Or do you mean Medicare? How is it that you have employer-sponsored health insurance and your husband is on Medicaid? That's not supposed to happen.
Posted: Wed Nov 14, 2012 07:38 pm Post Subject: Part B Vs Group Insurance
I am on disability and eligible for Medicare. Husband works for the USPS. Our Group policy is a Consumer Driven type plan. I understand that that would be the Primary Policy if I elected Part B. Is there any advantage in having both Group Insurance AND Medicare part B?
Posted: Thu Nov 15, 2012 04:31 am Post Subject:
There is no benefit or need to be on both an employer's group pan and Medicare Part B -- unless the group plan doesn't cover something that Medicare does. But Part B, which only pays for physician's expenses and outpatient hospital expenses, is unlikely to provide a better benefit (a possible exception would be if your physician is not in your group health plan's network -- generally unlikely).
A different consideration is that with enrollment in both Medicare Parts A & B, you can substitute those benefits with a Medicare Advantage plan (HMO/PPO) which could offer you a lower cost alternative. Talk to a local agent offering Medicare Advantage plans to explore your options.
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