Community Chat

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@SeaMaiden wrote:

I just recently signed up for Medicare.  I am also have Premera Blue Cross with my Husband's work insurance.  How do you know which one is your primary?  It all gets so confusing with two insurance plans.

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The employer will know.

My employer's policy is Medicare is primary.

And If Medicare denies a service/procedure, my employer insurance will deny also, even though if I didn't have Medicare, they would pay.  Go figure

[Carmie]

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@NicksmomESQ wrote:

     To clarify.My husband works for a company with over 20 employees,therefore his company sponsored medical is primary.If you work for a company with less than 20 employees than Medicare is primary. That's what DH was told.

   You should check it out with his H R dept.

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You are 100% correct.  That is the law.  The information can be found on the Medicare website in case anyone wants to look it up.

[Kachina624]

In my case, Medicare is always the primary insurance.  Some people have no supplement so coverage stops at the Medicare maximum.  If you do have a supplement, then it kicks in and pays the rest to its maximum.  It's an addition to Medicare; it supplements it.

The correct answer to  @SeaMaiden question is "it depends".  Always best to go to the source for Medicare questions. 

https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/who-pays

[HiLo]

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@chrystaltree wrote:

Your private insurance is always your primrary insurer.  Medicare would be your secondary.

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In my own case, all claims are sent first to Medicare and they in turn send them to my Insurance Co. to pick up any remaining balance   Don't understand the difference but I worked for the Federal Government.

[SeaMaiden]

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@chrystaltree wrote:

Your private insurance is always your primrary insurer.  Medicare would be your secondary.

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@chrystaltree   I found out the answer. 

 IF MY HUSBAND WAS STILL WORKING  his insurance( BLUE CROSS) would be my Primary. 

But since he is retired,  and I am on his insurance still, his insurance becomes  the secondary and Medicare is my primary.

  When my husband goes on Medicare ( when he starts to take Social security), then medicare will become HIS PRIMARY ALSO and the blue cross will become his secondary

[Daysdee]

In our case Medicare is primary and our previous insurance (through employer) became secondary.   Also, if Medicare rejects a claim our secondary insurance will not pay anything.

[SeaMaiden]

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@Daysdee wrote:

In our case Medicare is primary and our previous insurance (through employer) became secondary.   Also, if Medicare rejects a claim our secondary insurance will not pay anything.

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@Daysdee   I find that strange as we are paying a pretty penny for  the Premeria Blue Cross..  which is much better coverage than the Medicare.... I would think that they would pick up anything Medicare did not cover?? What  insurance is your Secondary?

[PodyPo]

@SeaMaiden

Yes it is complicated. Please check with both your husband's insurance company AND Medicare. I had BCBS through my job and also Aetna Medicare. I checked with my employers BCBS Advisor and was told Medicare would be primary. After a year and a half I started getting questioning phone calls from Aetna Medicare. One month later a slew of invoices started coming in. I had a biopsy and a week hospital stay along with many diagnostic tests during that time period. It turns out Aetna Medicare was not supposed to be primary and proceeded to revoke all of their payments going back 1.5 years to the start. I am still trying to wade through all the statements to determine what, if anything, I am responsible for paying. BCBS is now paying some charges but it may take a while to all get straightened out. Please double and triple check and then watch your EOBs as they come in. Good luck,

[PodyPo]

@patbz

No, this is not accurate. Please check with both your insurance company and Medicare. Ask for the Coordinator of Benefits department.

[SeaMaiden]

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@NicksmomESQ wrote:

  From what I've been told private insurance is usually primary over Medicare.You should double check this with the Human Resources dept. of your husbands job. That is what was told to my husband by his H R dept.

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@NicksmomESQ   From what I found out, it all depends on if  husband is working or retired.  Since my husband is retired, and I am on medicare, medicare becomes my primary, his insurance is my secondary..  If my husband was still working , then his work insurance would be my primary.