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In searching for an answer to the this question,
Google'd for "Medicare Secondary Payer provision;"
this website question was one of the top. hit's
after researching found the following: I called Medicare and asked them.
Medicare told me that since my spouse,who is not working, is eligible for medicare and is currently covered by my insurance that Medicare would be secondary. Also in looking thru documentation on the internet it looks to me as if what Medicare told me on the phone is correct that My Primary Insurance would still be primary Insurer and Medicare would be secondary. Extracted and underlined relevant information from links below is my understanding of Medicare as Secondary "Medicare benefits are secondary payer to large group health plans (LGHP) for individuals under age 65 entitled to Medicare on the basis of disability and whose LGHP coverage is based on the individual s current employment status or the current employment status of a family member. Under the law, a LGHP may not "take into account" that such an individual is eligible for, or receives, Medicare benefits based on disability" Also some companies are starting to charge employee extra for coverage of spouse if the employee's spouse can get insurance thru her employment or disability. Let's call it "Spouse Extra Charge".
To the point of the "Spouse Extra Charge", my spouse is not employed and according to above in purple should be eligible for the "Spouse Extra Charge" waiver and not charged the "Spouse Extra Charge".
"employers charging extra for Health Insurance for Spouse"
Some companies are charging from $10 to $110 extra a month to the premium for adding spouse if spouse can get insurance at their own employment.
Links are below for medicare primary or secondary I found the following at ssa.govhttp://www.ssa.gov/disabilityresearch/wi/medicare.htm
part of link below at A and from theMedicare Secondary Payer (MSP) Manual http://www.cms.hhs.gov/manuals/downloads/msp105c01.pdf
part of link below at B A start of excerpt from http://www.ssa.gov/disabilityresearch/wi/medicare.htmCoordination of Medicare and Other Coverage for Working Beneficiaries with Disabilities Question: I am under age 65, disabled, working and have both Medicare and group health coverage. Who pays first? Answer: It depends. If your employer has less than 100 employees, Medicare is the primary payer if: * you are under age 65, and * have Medicare because of a disability. If the employer has 100 employees or more, the health plan is called a large group health plan. If you are covered by a large group health plan because of your current employment or the current employment of a family member, Medicare is the secondary payer (see example below). Sometimes employers with fewer than 100 employees join other employers in a multi-employer plan. If at least one employer in the multi-employer plan has 100 employees or more, then Medicare is the secondary payer for disabled Medicare beneficiaries enrolled in the plan, including those covered by small employers. Some large group health plans let others join the plan, such as a self-employed person, a business associate of an employer, or a family member of one of these people. A large group health plan cannot treat any of its plan members differently because they are disabled and have Medicare. A large group health plan must offer the same benefits to plan members and their spouses that are over 65 and disabled as are offered to employees and their spouses under 65. Example: Mary works full-time for GHI Company, which has 120 employees. She has large group health plan coverage for herself and her husband. Her husband has Medicare because of a disability. Therefore, Mary's group health plan coverage pays first for Mary's husband, and Medicare is his secondary payer. A end of excerpt from http://www.ssa.gov/disabilityresearch/wi/medicare.htm B start of excerpt from http://www.cms.hhs.gov/manuals/downloads/msp105c01.pdf 10.3 - Disabled Beneficiaries Covered Under a Large Group Health Plan (LGHP) (Rev. 1, 10-01-03) Medicare benefits are secondary payer to large group health plans (LGHP) for individuals under age 65 entitled to Medicare on the basis of disability and whose LGHP coverage is based on the individual s current employment status or the current employment status of a family member. Under the law, a LGHP may not "take into account" that such an individual is eligible for, or receives, Medicare benefits based on disability. ---------text excluded----- Medicare benefits are secondary to benefits payable under a LGHP for individuals under age 65 entitled to Medicare on the basis of disability who are covered under a LGHP as a result of the:
Individual's current employment status with an employer that has 100 employees or more (see chapter 2, �30.3); or
Current employment status of a family member with such employer.
Special rules apply in the case of multiple employers and multi-employer plans. (See Chapter 2, �30.3.) Medicare is secondary for these Medicare beneficiaries even though the employer policy or plan contains a provision stating that its benefits are secondary to Medicare benefits or otherwise excludes or limits its payments to Medicare beneficiaries.
Medicare is secondary payer to LGHP coverage based on an individual s or family members current employment status for services provided on or after August 10, 1993. B end of excerpt from http://www.cms.hhs.gov/manuals/downloads/msp105c01.pdf == ==
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How do you get medicare as your primary insurance if you have horizons select as your primary you want to change?
You cannot decide which insurance is primary and which is secondary. Their is nothing you can do to determine this. Within each policy it specifies when each policy is primary or secondary. With Medicare, it is always going to be secondary to insurance provided by an employer or retirement plan.
Would Medicare be your primary or secondary insurance?
We have Medicare and added on Anthem. Does that mean Medicare is primary (Paying 80 percent) , and Anthem is secondary?
How do you determine primary and secondary coverage for an adult patient covered by two full benefit polices?
Check this page for the answer http://www.steveshorr.com/law_relating_to_insurance.htm primary policy will be medicare&secondary will bethe patient's commercial insurance company.as medicare covers all.the remaining which is not allowable wiill be covered by secondary
Do you obtain a authorization for secondary ins when medicare is primary?
after getting the payment from medicare (Primary) then secondary (X/Y/Insurance should pay even if there is no auth. And only this happens if secondary insurance follow medicare guidelines.
Can medicare be used for secondary insurance if the primary insurance is paid by your employer?
Medicare is primary if your group is under 20 lives. 20 lives or more and medicare is secondary to your employer paid group plan.
You want blue cross to be primary and medicare to secondary can you do that?
No. There is a federal law that requires Medicare is a secondary payer. You can find more information on the CMS website under "Medicare Secondary Payer and You."
If a patient has medicare primary and medicaid secondary what payment is the patient responsible for?
WHEN MEDICARE IS PRIMARY, THE PATIENT IS RESPONSIBLE FOR THE SECONDARY COPAY.
If a small group is in a PEO is medicare primary or secondary?
Medicare is always the primary insurance unless someone is still working
Retiree health care coverage and Medicare?
Question isn't clear, but ordinarily Medicare is the primary payor and your retiree coverage is secondary.
If a person has two health coverage plans which one is primary?
if you have medicare,retired but spouse works.spouse ins is primary and medicare secondary. if you are a child both parents has anthem,birthday rule has to apply. the parent who is born first is primary and the parent who is born later is secondary does not matter if parents are married or not
Is Aetna Medicare primary over Medicare?
The answer depends on what type of Aetna Medicare Plan you have. If you have an Aetna Medicare Supplemental Plan, then Original Medicare pays first and the Aetna plan pays secondary If you have an Aetna Medicare Advantage HMO Plan, then the Aetna plan will always be primary as Medicare has assigned the benefits over to Aetna for processing and administration.
I had group health ins from my wife Medicare was my secondary -- disability We've lost group health Do I need to call Medicare to switch from secondary to primary?
Yes -- It is ALWAYS best to call to coordinate your benefits
