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Medicare Part B Coverage Advice?

April 4, 2010

I am still working at 67 and covered by BCBS (Blue Cross Blue Shield) 80/20. I recently was required to have a lumpectomy; so I am getting some extraordinary bills with lots more to come due to radiation treatments.

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If I quickly get Medicare B as my secondary, will they pick up the slack? I surely could use the help.

By Grace from Charlotte, NC

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Bronze Feedback Medal for All Time! 186 Feedbacks
April 4, 20100 found this helpful

I'm not sure on this, but I would think in order for Part B to pick up the slack, you would have to be on it before hand. Everybody that I know is on A and B plus having supplemental insurance besides.

 

Bronze Feedback Medal for All Time! 107 Feedbacks
April 5, 20100 found this helpful

I would call social security and ask. Medicaid will go back 3 months if you have financial problems so maybe medicare has a similar provision.

 

Silver Feedback Medal for All Time! 450 Feedbacks
April 6, 20100 found this helpful

Just call them and ask.

 

Gold Feedback Medal for All Time! 949 Feedbacks
April 6, 20100 found this helpful

You need to check with SS or Medicare as there are rules about "first time users" and effective dates.
I do not believe they will go back but should cover everything after it is effective.

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You may have been better off to have enrolled as soon as you were elligible as you may pay more per month now.
Be sure you compare all supplements closely as there are differences in Medicare Part B and all the other plans.
Most other plans do not have good coverage for re-hab care and you never know when that will be necessary.
You can change later but only once a year time frame.
Good luck and I would not put it off too long.

 
April 7, 20100 found this helpful

I have Blue Cross Federal Employee (retired; live in Louisiana). Blue Cross would be your secondary; Medicare primary... that's what I was told when I turned 65. The Blue Cross people told me that my premium would not go down even when I have Medicare as primary.

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This actually doesn't apply to your question but thought it would be good to know.

 
April 7, 20100 found this helpful

Well...Yea!
According to my last call to Medicare, and visit to the SS office, Medicare Part B DOES process secondary claims when you are a holder of Part A and you are working full time and covered by a group insurance plan. (Earlier call to Social Security apparently gave me the wrong information.) What's more, it can become active the first day of the month you submit your request.
It is best to go to the SS local office to submit the form in order to get it processed in front of your eyes. I think I am set! With those bills coming in, I am greatly relieved. My monthly payments will be $110.50. Grace

 
April 8, 20100 found this helpful

As a former customer service rep for BCBS IL, let me try to explain how this will work.

BCBS will be your primary until such time as you are no longer working, once you retire then medicare will be your primary. Both your BCBS plan & medicare Part B are 80/20 plans, both plans have a non duplication of benefits clause. What that means is that when the 2nd insurance processes the claim, they will process as if they are the only insurance involved. Once they determine how much they would normally pay on the claim they then take a look at how much the primary paid. If what the primary (BCBS) has pd is greater than what the 2nd (Part B) would pay if only insurance involved then no payment will be made. If the payment from primary is less than what the 2nd would normally pay then the 2nd will pay the difference between the two.

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At this point in time it would seem like you would be spending money unnecessarily for Part B. I would suggest you call the customer service number on the back of the card for BCBS & verify with them what your out of pocket maximum is. Once that max is met then your BCBS policy will start to pay 100%. I am sure you are aware that by using innetwork providers you are getting the better discounts than non network providers. As far as having to pay more for Part B because you did not take it as soon as you were eligible, this will not apply to you as you were still working & covered by a group policy. Same for medicare Part D for the drugs.

 
April 9, 20100 found this helpful

You better get medicare part B. Most primary ins. require it to provide their portion of the coverage. if you do not get it your BCBS may(WILL) decline paying their portion of the bill.

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I'm sorry for sounding so forceful BUT I know someone who was forced to pay entire surgurical bill due to neglecting to take Med Part B.

 
May 15, 20100 found this helpful

I'm still working, on my company plan. I turn 65 in September. I'm told I need to apply for Medicare in July. I know nothing about all this, basically. What do I need to do?

I keep getting all this junk mail from supplement companies. My impression is that I really don't need to purchase a supplement until I actually retire.

Helllllllllllllllllllllllllllllpppppp!!!!

 
July 14, 20100 found this helpful

If you still have questions I would be happy to answer all that I can.
Thank you
Brad

 
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Bronze Post Medal for All Time! 216 Posts
June 3, 2011

I am 55. Two and 1/2 years ago, I became permanently disabled. This meant that I lost all medical insurance, and didn't qualify for Medicare until later this year.

My question is about Part B. For my budget, it is extremely expensive, and I don't know how I can cut back more. For those of you who have it, is Part B worth the cost?

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I will explain my circumstances a bit more: when I lost my medical insurance, I was very blessed to find a medical clinic that gives excellent care. I pay a very low fee to see my nurse practitioner (who I love!) and get routine tests, and x-rays for free. When I ended up in the hospital for a few days, I got rated at the county, teaching hospital, and get hospital care and non-routine tests almost free. The clinic I go to helped me apply to drug companies, and I get some of my medications for free. Like I said, I am blessed!

My interest in Part B would be to see that the clinic I go to gets paid more than I can pay, for home health services, for durable medical equipment, and because I am told they will pay for glucose test strips and meters, an expense that is very difficult for me to pay.

If you have Part B and could enlighten me a little, I would really appreciate it. I want to make it clear that I am not complaining about my situation. It could be a whole lot worse, as I well know, and I have had many, many blessings. I have nothing to complain about, just a lot of questions. Thank you.

By Free2B from North Royalton, OH

Answers

June 4, 20110 found this helpful

You are lucky that being you have medicare that you can still get help with medical assistance from local sources. When I was old enough to get medicare the free clinic told me I would have to quit going there, Which at that clinic a patient saw third year residents that rotated every three months. There was also a supervising physician and 2-3 nurses. Where I live there is no free hospital care available. If you are low enough income you should be able to get help from your state to pay the deductable, etc. on your medicare part B. Anyway that is the way it is in SD, there are two forms of medicaid for this issue. One form just pays your deductable, etc. The other pays for medical, dental and eyes. I would check into that.

 
June 4, 20110 found this helpful

I forgot when you get to where you qualify for medicare part D, the pharmeceutical companies will probably tell you that even if you don't apply for part D, they will drop you from the free program. This happened to me when part D went into effect, now instead of getting my meds completely free, I have to make a co-pay, which comes to about $10.00 a month, so far.

 
June 6, 20110 found this helpful

My husband is on disability and I work as much as I can, but with three kids money is tight. We applied through the county job and family services for benefits, and we qualified for the state of Ohio to pay for Medicare Part B for us. It would be worth looking into. When my husband goes the hospital, Medicare pays and then we get billed 80% for which I apply for assistance and we end up owing nothing.

 

Gold Post Medal for All Time! 846 Posts
June 6, 20110 found this helpful

Copasetic, I am being transfered from Medicaid to Medicare as of September 1st so you and I must have become disabled right around the same time. From what I understand if you receive SS disability you will receive part B. There are also programs for discounted part D. I am 57 and currently asking oodles of questions about Medicare from others who are disabled and via my local SS office before going on to Medicare (so as not to have any unexpected surprises) and have received quite a bit of info so far but still more questions to ask. Am going to send you a personal message with my email address and phone number. Everything will definitely change once you're on Medicare so maybe we can help one another get through the switch over sharing information.

 
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March 8, 2016

My husband works at a DOD-funded research lab (private university) so his benefits are great. At retirement his benefits will include lifetime health care coverage for a nominal annual premium.

I'm 57 and already retired due to a permanent disability, and receive SSDI. As my need for durable medical equipment (DME) increases - more mobility aids, a scooter now, motorized wheelchair in the future - am I better off switching to Medicare Part B before age 62?

I just assumed I should stay on our BCBS HMO plan, but now I wonder as there doesn't seem to be as much coverage for the things I need that are expensive, like putting in a ramp :(

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October 11, 2018

Does my coverage thru the Federal Government allow me to delay Medicare Part B so that I can also use TriCare? I'm reading that my coverage with the Blues will allow me to delay enrolling in Part B, but it is unclear if this means I can still use TriCare.

The online says that I must have Part B coverage to retain TriCare. I'll still continue to keep my coverage by BC/BS.

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November 2, 2019

I'm 62 years old and a retired government employee. I am on my husband's federal plan BC/BS family, FEP 105. He was a DC police officer and they never contributed to Medicare (we found out too late), and so he has to keep BC/BS.

I understand he can pick up Part A under me now that I'm 62? My other question is should I just keep BC/BS and pickup Part A? or can I still get Medicare B and still be under his BC/BS? Not sure how that would work?

Answers

November 7, 20190 found this helpful
Best Answer

I used to work for Medicare a while ago, and if my memory serves me right, if you qualify because of your age, and you are married, then he should be able to pick up part A under you. I don't want to give you the wrong advice, but to make extra sure you should call this number. 1-800-772-1213

 

Gold Feedback Medal for All Time! 949 Feedbacks
November 9, 20190 found this helpful
Best Answer

Medicare is only available when a person reaches 65 years of age (unless they are disabled) so right now you will need to have insurance and since you are already on your husband's BC/BS that is what you should be checking on.
Here is a link that explains about Medicare part A & part B:

www.hhs.gov/.../index.html

I believe you have a few years before you will be eligible for Medicare and there could be changes before that happens but you might want to check out your BC/BS policy to make sure you both have the coverage you need.
There are a lot of other plans but most are very expensive (without Medicare A&B) and most likely your husband has a good deal since he is a retired police officer.

Insurance policies are sometimes very difficult to understand so maybe you and your husband could discuss your plans with a BC/BS representative as they can also advise you on what will happen when you turn 65 and become eligible for Medicare.

 
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