medicare

[dbel]

Hello. I had been on fmla during the end of 2023 and then officially retired in January 2024 at the age of 54 at which I started to receive LTD. LTD had me apply for ssdi. I was approved for ssdi and recently received notice that I was approved for Medicare. My husband added me to his Kaiser insurance during last year's open enrollment knowing that my medical insurance would end soon. My husband's insurance seems to be meeting our needs, such as doctors' appointments as well as my medication which are mainly riluzole, sleep aids and anti sialorrhea medications and enteral feeding supplies. I'm not sure about DME and I have a wheelchair assessment scheduled in April. My questions are:

• is Medicare or my husband's insurance primary
• will having Medicare be more helpful or hurtful to have in conjunction with my husband's insurance
• i am eligible to continue on my insurance through cobra but not sure if that is worth pursuing
• is there a time limit of when I can opt of medicare

Any suggestions that you might have would be greatly appreciated. Thank you in advance.

 

[Nikki J]

I think it is fairly complicated. Whether medicare is primary or secondary depends on how many employees your husband’s company has

This page might help How Medicare works with other insurance

There is probably no reason not to get part a which is usually free. That is hospital in patient coverage. B and d cost money. If you have good coverage without and it is creditable ( meaning medicare considers it adequate) you wouldn’t be penalized for late sign up. Your husband should also check whether you being medicare eligible now affects their coverage somehow. It is not unusual with 65 plus workers that there is some requirement they take medicare

 

[dbel]

Thanks Nikki. The link you provided was super helpful. It looks like his insurance would be primary as they have more than 100 employees. If I just do part a for now, can I add part b and d in the future during medicare's open enrollment.

 

[lgelb]

Yes, but I would check first that having Medicare eligibility or coverage (any part) doesn't make Medicare primary. That page doesn't say that it can't be. The 100-employee thing in that particular clause is if HE is retired, not you. They can write their plan differently relative to dependents under certain circumstances.

Always check with and get a written statement from HR at HQ if he works at a branch.

 

[KimT]

Also, make sure whatever combinations of plans you have pays for durable medical equipment. I stayed on the college's policy as long as I could because they covered drugs 100% but want to Medicare with a supplement because they covered all my durable medical equipment. Medicare Part B and Supplement G paid for 100% of two power wheelchairs (five years apart) and will pay 100% of BiPap.

Just make sure. You may have the opportunity for several open enrollments. If you're going with your husband's insurance and Medicare, if your husband's insurance changes, you most likely will have a new open enrollment. Same when you turn 65. My part B supplement premium dropped from $600 a month to $170 a month when I turned 65.

I agree with Laurie. Get something written from HR and sit down with them to get a complete explanation of the benefits and how their plan works with Medicare.