Private Insurance And Medicare, Health Insurance Rates And Cost

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Most employers cannot require employees (or their spouses) who turn 65 to sign up for Medicare, but must offer them the same benefit options as younger employees (and their spouses). If you do sign up for Medicare as well (which is your choice), your employer plan is primary and Medicare serves as secondary insurance. The exception is if your employer has fewer than 20 workers (or fewer than 100 if you have Medicare through disability), in which case Medicare usually becomes primary. The primary insurance pays your medical claims first and the secondary insurance pays for any services that it covers but the primary insurance doesn’t. So if your health insurance comes from a small employer, it’s important to check whether or not you are required to sign up for Medicare—because if you are, but you fail to enroll, you would be left with essentially no insurance at all. 

Medicare Information and Guidance On Costs, Coverage

3. Do enroll when you’re supposed to: To avoid permanent late penalties, enroll at age 65 if you don’t have insurance from an employer for whom you or your spouse is still working or if you live abroad without working; or, beyond 65, enroll within eight months of stopping work — even if you continue to receive COBRA or retiree health benefits from an employer.

Medicare Provider Utilization and Payment Data

CMS has released a series of publicly available data files that summarize the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals, physicians, and other suppliers. These Medicare Provider Utilization and Payment Data files include information for common inpatient and outpatient services, all physician and other supplier procedures and services, and all Part D prescriptions. Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount that providers bill for an item, service, or procedure.

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