67 and took my wife work insurance..

[Bruno]

When i retired at 66 it seemed for a few more dollars i could get on my wife health insurance plan that gave me a better Rx plan, vision and ect.

Now at 67 I had to have a heart valve replacement and bypass so now wondering how it works. Bills are coming in and got a form to fill out from insurance company to list what if any other insurance coverage.

Will my wife insurance be my primary and pay off what it covers and then medicare part A pay any extra? Just don't know if medicare will even be involved at all.

Thanks for any input on this matter,

[SumDay]

It depends on how your wife's plan is written. The megacorp I retired from made Medicare the primary insurance for spouses. The megacorp DH retired from made Medicare secondary, meaning megacorp paid first, Medicare picked up the remainder.

Get an SPD (Summary Plan Description) for her plan. Look for the Coordination of Benefits Section. If you don't understand what it says, post the language here and we'll try to figure it out. Figuring out COB can be a pain.

[Teacher Terry]

For us Medicare was primary.

[Bruno]

Thanks SumDay, I found the SPD and trying to figure out what it is saying several pages long. I may need to either post it or PM it to you.

Bruno

Quote:

Originally Posted by SumDay It depends on how your wife's plan is written. The megacorp I retired from made Medicare the primary insurance for spouses. The megacorp DH retired from made Medicare secondary, meaning megacorp paid first, Medicare picked up the remainder. Get an SPD (Summary Plan Description) for her plan. Look for the Coordination of Benefits Section. If you don't understand what it says, post the language here and we'll try to figure it out. Figuring out COB can be a pain.

[pacergal]

If you can't figure it out from the written info, Can you call your wife insurance plan and see if they are the primary or secondary to Medicare?

[Bruno]

I got a insurance statement today and its says primary is Wife's insurance. There is nothing listed as secondary. Does that mean i only have wifes insurance? It seems medicare people told me once medicare B was not a supplemental insurance.

Quote:

Originally Posted by pacergal If you can't figure it out from the written info, Can you call your wife insurance plan and see if they are the primary or secondary to Medicare?

[SumDay]

Quote:

Originally Posted by Bruno I got a insurance statement today and its says primary is Wife's insurance. There is nothing listed as secondary. Does that mean i only have wifes insurance? It seems medicare people told me once medicare B was not a supplemental insurance.

I think you need to call your wife's insurance AND your Medicare supplement, and I have had to have both of them on the phone at the same time, which is interesting, to say the least. If you don't get it straightened out, you could end up paying out of pocket, which shouldn't have to be done when you have dual coverage.

[ivinsfan]

Bruno this won't help you now but for others reading, MVR is not usually an emergency, far better to ask this question before the surgery for your own peace of mind. Having said that, pretty sure the hospital/surgeon verified you had insurance coverage before putting you under the knife. If for some reason you owe a large out of pocket ask the provider for an adjustment due to the confusion. They won't offer you will have to ask.

[Bruno]

I also had to have 2 bypasses so not sure the MVR would have worked. They do MVR but are not pushing it. Said the MVR valve not lasting over 5-7 years.

Quote:

Originally Posted by ivinsfan Bruno this won't help you now but for others reading, MVR is not usually an emergency, far better to ask this question before the surgery for your own peace of mind. Having said that, pretty sure the hospital/surgeon verified you had insurance coverage before putting you under the knife. If for some reason you owe a large out of pocket ask the provider for an adjustment due to the confusion. They won't offer you will have to ask.