Question 2 : How does my insurance work with Medicare?

When you have other insurance aside from Medicare, there are rules on whether who pays first.

If you have a Retiree Insurance, Medicare pays first.

If you are 65 years or older and you have a group plan coverage based on your or your's spouse's current employment and the employer has 20 or more employees, your group health plan pays first.

If you're under 65, have a disability and a group health plan coverage based on your or your family member's current employment, and the employer has more than 100 or more employees, your group health plan pays first.

If you're under 65 and have a disability and the employer has fewer than 100 employees, Medicare pays first.

If you have Medicare because of End-Stage Renal Disease (ESRD), your group health plan will pay first for the first 30 months after you become eligible to enroll in Medicare. Medicare will then pay after this 30-month period.

If you have Medicaid, Medicaid pays first.

IMPORTANT FACTS TO REMEMBER:

The insurance that pays first pays up to the limits of its coverage.
The insurance that pays second only pays if there are costs the primary insurer didn't cover.
The second payer (which may be Medicare) might not pay all of the uncovered costs.
if your employer insurance is the second payer, you might need to enroll in Part B before your insurance will pay.

For more information, visit Medicare.gov/publications or call 1-800-MEDICARE. TTY uses can call 1-877-486-2048.

Mga Komento

Mga sikat na post sa blog na ito

Durable Medical Equipment and Medicare

Medicare Part B covers the D urable Medical Equipment (DME). These are equipment that serves a medical purpose, able to withstand repeated use, and is appropriate for use in at home. There are many important things to know about Medicare’s coverage for DME. Below are pieces of information that will help you know whether/how you are covered. Eligible equipment Medicare’s DME benefit does not cover all medical equipment. Medicare only covers DME if your provider says it is medically necessary for use in the home . You also must order your DME from suppliers who contract with Original Medicare or your Medicare Advantage Plan . However, Medicare Advantage Plans may have additional requirements you need to meet before your DME is covered. DME coverage Depending on what type of equipment you need, Medicare will require that you either rent or buy DME. There are also special rules when you need oxygen equipment...

Magbasa nang higit pa

Medicare & group health plan after you retire

Will my group health plan still work after I retire? It would depend on the terms of your specific plan. Other employers might not offer any health coverage after your retirement and even if you can get one, it might have different rules and might not work the same way with Medicare. When you have retiree coverage from an employer or union, they usually manage this coverage. Employers aren't required to provide retiree coverage, and if they would, they can change benefits or premiums, or even cancel coverage. They may offer coverage that limits how much it will pay. It might only provide a stop-loss coverage that starts paying your out-of-pocket costs only when they reach of coverage that's covered. What happens to my retiree coverage when I'm eligible for Medicare? When you become eligible for Medicare, you will need to have both Medicare Part A and Medicare Part B to get full benefits from your retiree coverage. If your former employer offers retiree...

Magbasa nang higit pa

Medicare Part D Costs for 2020

Before 2006, Medicare did not cover prescription medications. There was a limited number of medications that were offered under Medicare Part Band, and otherwise, you had to pay for your medications out of pocket. In 2003, everything had changed when President George W. Bush passed the Medicare Prescription Drug, Improvement, and Modernization Act (MMA). This is what we now know of as Medicare Part D , an optional part of Medicare that provides prescription drug coverage. Part D plans are run by private insurance companies and not by the government. However, the federal government sets guidelines on what basic medications are covered and how much you can be charged. A deductible is the amount of money you spend out of pocket before your prescription drug benefits begin. Your plan may or may not have a deductible. The maximum deductible a plan can charge for 2020 is set at $435. It has increased by $20 from 2019...

Magbasa nang higit pa

Hanapan ang Blog na Ito