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Medicare less than worthless if secondary?
posted at April 30, 2013 1:46 PM EDT
Re: Medicare less than worthless if secondary?
posted at June 1, 2013 9:54 PM EDT
First: January 28, 2008
Last: March 8, 2014
In Response to Medicare less than worthless if secondary?:
I am over 70 and therefore must take Social Security. I have a employer sponsered High deductible Health plan ($3000/$6000 out of pocket max family), Last year my wife had a 50 day hospitalization, starting Jan 2nd 2012 with no previous expenses from my primary plan. My cost, $6000, Medicare's cost 0. Why, because priimary insurance paid doctors and drugs in Feb- April before paying hospital from January. When Hospital was finally paid there was no remaining deductible/ out of pocket. On paper the hospital was paid in full by the primary. Really useful part A! Yet, having part A, I can not have a health Savings account that would have saved significantly on Medical expenses. My fix? This year my wife has part B she does not need with her primary plan, simply to protect her part A. It actually makes sense if you have issues that make hospitalization likely. We will come out close to even if there is no hospital admission, and ahead if there is. As part of the High Deductible plan, I have drug coverage, once the deductible is spent. But it is not creditable, so wife and I have part D plan to avoid penalties. I take no drugs, yet pay for coverage. Wife needs lots of drugs, but COB fails, and many of her drugs, when processed through both plans cost significantly more than wnen processed through just the primary plan. One drug paid at 100% by the primary plan costs $22 with Medicare D secondary. I suspect the calculation is wrong, but I cannot interest anyone in fixing. Perhaps you sense I am frustrated by being ripped off by a system that is supposed to help. Am I the only one?
Posted by jsfrost
You may want to post in the Insurance and Medicare GROUP which has many members.
Most insurers and the VA will use Medicare as the first payer I believe. The problem with nopt signing up for "B" or "D" when you become eligeable is that there may be a premium penalty for late sign upunless you have "equivalent" coverage from another insurer.