Need Advice: Great Private Insurance - Smart to Delay Medicare?

[cfoughty]

My private insurance is great, and they won't force me to go on Medicare for two years. When I do go on Medicare, Medicare is 1st pay.

I was just approved for SS disability and automatically given Medicare. I have 30 days to cancel.

Should I cancel medicare now?

 

[notme]

Weigh the pros and cons. How much is your private insurance? Does it have a lower co-pay than Medicare does for the items you're going to need? Power chairs, bi-pap, beds, etc? Some insurance policies are really bad as far as durable medical equipment goes.

Will the private stick with you as the secondary if you keep it? Will your doctors take the medicare insurance? Just a few of the things to consider before deciding.

 

[cfoughty]

DME is great - 90% and covers everything, the private insurance will stay as 2nd payer, and the premiums are very reasonable. My doctors take Medicare.

 

[Katie C]

If you can maintain your current company as medicare supplemental, and keep all your doctors, etc, go for it... use the money you save to treat yourself to something nice!

 

[Lobster]

Good private insurance companies often pay for better wheelchairs than Medicare. Similarly, some equipment that Medicare will require you to rent is covered by private insurance sometimes.

Think strategically and do your homework. I mean that to encourage you, not as an admonishment. It stinks to add this to what you have and think about right now. I am guessing you have enough on your plate already.

My ALS clinic gave me good advice as to what would be covered by which and how much they would pay.

Good luck.

 

[brooksea]

Use both! Then you may not have any out of pocket, for a while! Durable medical equipment is expensive, so you could save a lot! 10% of the cost of a PWC, could be $4000. And those 10%'s will add up.

 

[caldona]

One thing to consider is does your insurance have the same deal going with Medical needs that medicare does. Like my computer the company billed Medicare over twelve thousand but Medicare said they approved a little over six thousand. I would have to think real long on giving it up

 

[Lobster]

Use both! Then you may not have any out of pocket, for a while! Durable medical equipment is expensive, so you could save a lot! 10% of the cost of a PWC, could be $4000. And those 10%'s will add up.

I don't think that is legal. When I was retiring, the benefits coordinator at my place of work said that if you have both Medicare and another plan, Medicare is by law your primary and the other plan is your secondary ("Medigap").

I suggest you check with your benefits coordinator at the place where you get your insurance now.

 

[brooksea]

What? That's what I meant. Use the other plan as secondary. I was saying (or what I meant) if the private insurance was kept and no Medicare, then the 10% co-payments would add up after a while. So, use both.

 

[Lobster]

What? That's what I meant. Use the other plan as secondary. I was saying (or what I meant) if the private insurance was kept and no Medicare, then the 10% co-payments would add up after a while. So, use both.

Oh, ok, I see what you mean now.

Thanks.

 

[shelleynshaggy]

If possible use both. Jim is still eligible for my plan so Medicare is his secondary. They pick up the co-pays for all specialist visits and what-not.

 

[mytwoboys]

In our situation, Medicare automatically became my husband's primary insurer and his (former) workplace insurer became secondary. It worked well for us; when he moved into the hospice facility near the end for 2 months, Medicare paid for the hospice services and our private insurer paid for the room and board - something that Medicare doesn't cover. If we didn't have the private insurance as secondary, we would have been responsible for $250 a day.

I'm not saying that all private insurers will pay the room and board for a hospice facility, but in some cases it can't hurt to keep them around.

 

[tmasters]

Do you take Rilutek or any other expensive medications? If so, be aware of the Medicare "donut hole" which probably isn't a factor for your private insurance.

When you gather your pros and cons data, make sure you determine your medicare premium. Depending on your income level in 2009, it may be higher than the "usual" amount. You can search the web for these premium rate tables.

I see no problem with opting out of Medicare for now. But make sure that if and when you do transition to Medicare, you give yourself 5-6 months to continue your private insurance while you wait for Medicare to kick in. You want this to go smoothly with no interruption.

-Tom

 

[Will]

This requires some analysis. In my PALS case, his BC costs $550/mo. Med is 115/mo. With a Medicare Advantage Policy $27/mo, the maximum out of pocket in a year is $3400. Medicare alone has no max out of pocket. Drugs are cheaper with BC, but it is only the Rilutek that is significant, and it is supposed to go generic in 2012, and the donut hole is supposed to close a bit more next year.

So when we factor all that in, going with the Medicare Advantage seems to be the best deal.

 

[notme]

Def. keep both--the donut hole keeps me out of meds bout 4 months out of the year, as my RX's cost over 1400 per month--more than I make.