My husband is turning 65 and will still be employed full time. Will Medicare or his Blue Cross he has now be his primary?
Patricia from Livonia, MI
Your best bet would be to call Medicare and ask them and then call Blue Cross and ask them. We have Kaiser insurance and my husband has a Senior Advantage plan that is funded by medicare. We pay some to Medicare (about $98.) and some to Kaiser (not much more than that I think) and when he has a problem (such as a recent ER visit) they had to bill Kaiser. I am not doing a good job of explaining here, but we finally called both and found out that if it is a "senior" plan of some kind they (your ins, co.) are responsible. (02/14/2008)
Medicare will be the primary carrier and Blue Cross will be second. I am over 65 and have had Medicare for several years, along with a secondary carrier. Tell your husband Happy Birthday for me and God bless you. (02/15/2008)
Most likely as BC is through his employer, it will be primary. As a matter of fact, Medicare searches for this info to determine if they or the employers insurance is primary. He should have received a questionnaire from Medicare, asking this very thing. When in doubt, call Medicare or go to your SS office. Has he yet signed up for Medicare? A Medicare Advantage Program (Medicare Part C) will not sign you up if you have insurance through an employer, if you are still working. Always check right with the source, both Medicare and the employer's insurance. They both want to make sure which is primary. Save the headache later of having bounced claims and doctors asking for payments because of rejections. (02/15/2008)
Medicare is "always" secondary unless the policy is a medgap policy. In that case Medicare is the primary and the medgap policy is the secondary. Regarding the lady that said her Blue Cross was secondary, apparently her Blue Cross policy is a medgap policy. (02/15/2008)
Once a person retires, Medicare becomes the primary carrier and another insurance becomes the secondary carrier. This is true unless the person or their spouse is still employed and has insurance coverage, in which case all claims are run through the employer's carrier first and then Medicare second. However, in this second case, if the person goes to Medicare approved providers, they will never owe more than they would have if they were insured by Medicare alone.
Places often get charges mixed up, so be vigilant when you receive the Explanation of Benefits to make sure you were billed the correct amounts. Primary carriers often pay more than Medicare allows, so any balance will or should be written off rather than billed to you. Keep track of what is printed on all statements, and don't be afraid to call both insurance companies along with the physician's billing office. I've been told by more than one doctor's office that I owe money when it was supposed to have been processed differently, paid differently, and I actually had no balance.
I've also been told by several doctor's offices incorrect information, but knew better. I was an insurance clerk for 16 years and worked with Medicare. It may take a while to get through to Medicare, but that time has a price and can save you "big" money. (02/16/2008)
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