How Medicare works with other insurance

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A conditional payment is a payment Medicare makes for services another payer may be responsible for. Medicare makes this conditional payment so you won’t have to use your own money to pay the bill. The payment is “conditional” because it must be repaid to Medicare if you get a settlement, judgment, award, or other payment later. You’re responsible for making sure Medicare gets repaid from the settlement, judgment, award, or other payment.

Supplements & other insurance

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What Is The Best Secondary Insurance With Medicare?

To supplement Medicare it’s best to have a Medicare Supplement Plan. These are standardized plans in most states. The highest level of coverage is the Plan F Medicare Supplement. It pays 100% of the co-pays and deductibles for Medicare covered treatments. The others to consider are Plan G which is the same as Plan F except you pay your Medicare Part B deductible which is less than $150 per year currently. You will often save $200 to $300 annually on your premiums choosing a plan G supplement over a Plan F. You can also consider the Medicare Plan N Supplement for an even lower premium but you will take on more doctor co-pays and a few less benefits. There is a high deductible version of Plan F where you have a much lower premium but you pay the first $2,070 in expenses each year but are covered 100% for costs above that. Medicare and your supplement do not cover prescription medicines so most people buy a Medicare Part D plan for those. None of these plans cover dental or eye doctors so some people buy additional coverage for those. All companies sell the exact same standardized Medicare Supplement Plans so it is the easiest type of insurance to shop and compare and lower your cost. A Plan F with one company may be as much as $500 per year cheaper with a different company and the coverage is exactly the same. It’s best to use an insurance broker who sells for many companies rather than sign up directly through one specific company. When there is a rate increase (they ALL have them) your broker can just re-shop the plans for you and help you get back to a lower premium.

Medicare as a Secondary Insurance Customer

Often policies have a tendency to overlap or duplicate each other. Take young person’s Medicare health care plans for instance:  often these can reduce the amount paid out by a percentage via a ‘reduction in benefits’ clause, particularly if they are protected under their parent or guardian’s plan. Should this be the case, a secondary insurance policy will pay the balance that is not paid by the primary insurance policy.

Medicare can be primary or secondary to employer insurance

It is very important that you talk to your benefits manager at your job when you become eligible for Medicare, as your employer insurance will work differently with Medicare. Sometimes companies do not realize that you are eligible for Medicare and they may continue to pay primary when they should not be. When the company realizes they may be able to take back money they paid for your medical services while you should have had Medicare and you may be left very large bills.

Secondary Insurance for Medicare

If you choose to continue to pay for health insurance that you previously had through your employer, you can supplement group insurance to your Medicare. This is a great option, especially if the insurance coverage is substantial. Prescription coverage, hospitalization, office visits and outpatient coverage can all be applied to your current Medicare policy. Some group insurance programs offer additional coverage for specific conditions such as cancer treatments, durable medical equipment, home health care and hospice care.

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