Medicare Blog

why do i have to have medicare when i already have blue cross

by Kole Osinski Published 2 years ago Updated 1 year ago
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Does Blue Cross offer Medicaid plans?

The Centers for Medicare & Medicaid Services (CMS) and the State of Illinois have contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) along with other Managed Care Organizations (MCO) to implement Medicaid to all counties in Illinois.

What is Blue Cross Blue Shield customer service number?

We're here to help you better understand and use your health insurance. Our representatives are available via phone Monday through Friday from 7:30 a.m. to 6:00 p.m. (CT). Our building is closed to the public at this time. Telephone: 844-201-0763 Fax: 402-392-4153 Hearing and Speech Impaired (TTY/TDD): 711

Is Blue Cross Blue Shield a Medicare supplement?

Blue Cross and Blue Shield of North Carolina is an HMO, PPO and PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal. Blue Medicare Supplement is not endorsed by or affiliated with the United States Government or the federal Medicare program.

Is Blue Cross Blue Shield Medicare?

Though Anthem and Blue Cross Blue Shield both act as insurance middlemen, Blue Cross Blue Shield provides Medicare health benefits and prescription drug coverage in different parts of the country while Anthem offers Medicare for those in those areas.

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Is BCBS the same as Medicare?

BCBS companies have been part of the Medicare program since it began in 1966 and now offers multiple Medicare insurance options. Though quality and costs vary by company and by specific plan within those companies, most BCBS plans offer decent value and benefits across a range of health plan options.

What happens if you don't choose a Medicare plan?

If you don't switch to another plan, your current coverage will continue into next year — without any need to inform Medicare or your plan. However, your current plan may have different costs and benefits next year.

Is it better to have Medicare as primary or secondary?

Medicare is always primary if it's your only form of coverage. When you introduce another form of coverage into the picture, there's predetermined coordination of benefits. The coordination of benefits will determine what form of coverage is primary and what form of coverage is secondary.

Is Blue Shield Medicare or non Medicare?

Discover your healthcare needs Blue Shield of California is an HMO and PDP plan with a Medicare contract.

Do I automatically get Medicare when I turn 65?

You automatically get Medicare when you turn 65 Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care. Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services.

Can I opt out of Medicare?

If you do not want to use Medicare, you can opt out, but you may lose other benefits. People who decline Medicare coverage initially may have to pay a penalty if they decide to enroll in Medicare later.

Can I get Medicare Part B for free?

While Medicare Part A – which covers hospital care – is free for most enrollees, Part B – which covers doctor visits, diagnostics, and preventive care – charges participants a premium. Those premiums are a burden for many seniors, but here's how you can pay less for them.

Do retirees pay Medicare premiums?

Although Part A, which pays for hospital care, is free for most beneficiaries, you'll pay a monthly premium for Part B, which covers doctor visits and outpatient services. In 2022, the standard monthly premium will be $170.10, up from $148.50 in 2021.

Does Medicare as Secondary cover copays?

Medicare is often the primary payer when working with other insurance plans. A primary payer is the insurer that pays a healthcare bill first. A secondary payer covers remaining costs, such as coinsurances or copayments.

Does healthy blue cover dental?

Healthy Blue dental benefits include: Child and adult emergency outpatient dental services. No required copay for emergency care in a doctor's office or hospital. Ambulatory surgical center outpatient emergency dental services with prior authorization.

Why do doctors not like Medicare Advantage plans?

If they don't say under budget, they end up losing money. Meaning, you may not receive the full extent of care. Thus, many doctors will likely tell you they do not like Medicare Advantage plans because private insurance companies make it difficult for them to get paid for their services.

What is the difference between Medicare and Medicare Advantage plans?

Medicare Advantage is an “all in one” alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D. Plans may have lower out-of- pocket costs than Original Medicare. In many cases, you'll need to use doctors who are in the plan's network.

What percentage of Medicare coinsurance is required?

Coinsurance. You pay 20 percent for some medical services, such as doctor services, outpatient therapy and durable medical equipment. Preventive Care. No deductibles, copays or coinsurance are required for Medicare-covered preventive care services, such as annual wellness visits and mammograms for women.

When will Medicare Part A and Part B be automatically enrolled?

You will be automatically enrolled in Medicare Part A and Part B if you reach age 65 and receive Social Security or Railroad Retirement Board (RRB) retirement benefits. You will also be automatically enrolled if you are under age 65 with an eligible disability.

What is Medicare Part B?

Part B – Costs. Premium. Medicare Part B has a monthly insurance premium that is based on when you enroll and your annual household income. This premium is commonly paid through Social Security withholdings.

How long does Medicare Part A last?

Title. When to Enroll. Description. When you are first eligible, your Initial Enrollment Period for Medicare Part A and Part B lasts seven months and starts when you qualify for Medicare, either based on your age or an eligible disability.

What is open enrollment period for Medicare?

The Medicare Open Enrollment Period provides an annual opportunity to review, and if necessary, change your Medicare coverage. Below are some examples of changes that you can make during Open Enrollment:

How long does it take to sign up for Medicare?

The most convenient way to sign up for Medicare is online through the Social Security Administration's website. The application takes less than 10 minutes, there are no forms to sign, and there's usually no further documentation requirement. Try any of our Foolish newsletter services free for 30 days.

What age do you have to be to get Medicare?

The age of eligibility for Medicare is 65, and some people are enrolled automatically while others need to sign up. If you're already receiving Social Security or Railroad Retirement Board (RRB) retirement benefits, you'll automatically be enrolled in Medicare Parts A and B on the first day of the month you turn 65.

How long does the enrollment period last?

Your initial enrollment period lasts for seven months and includes the month during which you turn 65, as well as the three months before and after. If you choose not to sign up during your initial enrollment period, the general enrollment period runs from January 1 to March 31 each year, but you may have to pay a penalty in the form ...

How does Medicare work with other insurance?

When there's more than one payer, "coordination of benefits" rules decide which one pays first. The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" (supplemental payer) ...

How long does it take for Medicare to pay a claim?

If the insurance company doesn't pay the claim promptly (usually within 120 days), your doctor or other provider may bill Medicare. Medicare may make a conditional payment to pay the bill, and then later recover any payments the primary payer should have made. If Medicare makes a. conditional payment.

How many employees does a spouse have to have to be on Medicare?

Your spouse’s employer must have 20 or more employees, unless the employer has less than 20 employees, but is part of a multi-employer plan or multiple employer plan. If the group health plan didn’t pay all of your bill, the doctor or health care provider should send the bill to Medicare for secondary payment.

When does Medicare pay for COBRA?

When you’re eligible for or entitled to Medicare due to End-Stage Renal Disease (ESRD), during a coordination period of up to 30 months, COBRA pays first. Medicare pays second, to the extent COBRA coverage overlaps the first 30 months of Medicare eligibility or entitlement based on ESRD.

What is the phone number for Medicare?

It may include the rules about who pays first. You can also call the Benefits Coordination & Recovery Center (BCRC) at 1-855-798-2627 (TTY: 1-855-797-2627).

What happens when there is more than one payer?

When there's more than one payer, "coordination of benefits" rules decide which one pays first. The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" (supplemental payer) to pay. In some rare cases, there may also be a third payer.

What is a health care provider?

Tell your doctor and other. health care provider. A person or organization that's licensed to give health care. Doctors, nurses, and hospitals are examples of health care providers. about any changes in your insurance or coverage when you get care.

How to contact Blue Shield of California?

Call (800) 776-4466 ​.

Is Medicare primary or secondary?

Employer coverage and Medicare: If you work for a company with fewer than 20 employees, Medicare is considered your primary coverage. That means Medicare pays first, and your employer coverage pays second. If you work for a larger company, your employer-based coverage will be your primary coverage and Medicare your secondary coverage.

Does Medicare pay for spouse?

Coverage from your spouse’s employer and Medicare: If your spouse’s employer has fewer than 20 employees, Medicare pays first. If it's a larger company, the business's health plan pays first. After both insurers pay, you pay the balance.

Can you keep Medicare if you have California?

There is usually no reason to keep an individual or Covered California plan once you have Medicare. It is illegal for someone to sell you a marketplace or individual market policy. You are not eligible for tax credits or other savings, which means you would pay full price for a marketplace plan.

Does Medicare cover VA doctor visits?

Medicare covers your civilian doctor visits, and the VA covers your visits to VA facilities. Medicare may pay part of your copayment ...

Signing up for Medicare might make sense even if you have private insurance

Jeffrey M. Green has over 40 years of experience in the financial industry. He has written dozens of articles on investing, stocks, ETFs, asset management, cryptocurrency, insurance, and more.

How Medicare Works

Before diving into how Medicare works with your existing health coverage, it’s helpful to understand how it works on its own. Medicare has four main parts: A, B, C, and D. You can also purchase Medicare supplement insurance, known as Medigap.

Medicare Enrollment Periods

Medicare has a few enrollment periods, but the initial enrollment period may be the most important. This is when you first become eligible for Medicare. And if you miss the deadline to sign up for Parts B and D, you could face expensive penalties .

How Medicare Works If You Have Private Insurance

If you have private insurance, you may want to sign up for Parts A, B, D—and possibly a Medicare Advantage plan (Part C) and Medigap, once you become eligible. Or not. There are reasons both for and against. Consider how the following types of coverage work with Medicare to help you decide.

Primary and Secondary Payers

Your Medicare and private insurance benefits are coordinated, which means they work together. Typically, a primary payer will pay insurance claims first (up to plan limits) and a secondary payer will only kick in for costs not covered by the primary payer.

Frequently Asked Questions (FAQs)

No, you can delay signing up for Medicare without penalty, as long as you are covered by another type of private insurance. Generally, if you are eligible for premium-free Part A, you should still sign up for it, even if you have additional private insurance coverage. 18

What happens if you don't enroll in Medicare?

As a federal retiree, if you don’t enroll in Medicare, your FEHB plan will act as your primary insurer and won’t pay less because you qualify for Medicare.

How long before you can change your FEHB coverage?

You may want to make changes to your FEHB coverage when you are nearing Medicare eligibility, and will have the option to do this starting 30 days before you qualify for Medicare. Changes can only be made once during this window. You can also wait until FEHB Open Season to change your coverage. Back to top.

Can you suspend your Medicare Advantage plan?

You can suspend your enrollment in FEHB to enroll in Medicare Advantage or other eligible coverage by contacting your agency’s retirement system, and providing them documentation that you enrolled . If you do this , you’ll be allowed to leave your Medicare Advantage plan and return to FEHB.

Is FEHB covered by Medicare?

While FEHB plans cover most of the same types of expenses that Medicare covers, FEHB plans’ coverage may be more limited than Medicare Part B when it comes to orthopedic and prosthetic devices , durable medical equipment, home healthcare, medical supplies, and chiropractic care.

Can you pay Medicare excess?

Some states don’t allow excess Medicare charges. If you live in one of these states – or you see a doctor in any state that accepts Medicare’s rate as full payment – you’d only have to pay the difference between what Medicare and your FEHB plan pay and Medicare’s rate.

Can you reenroll in FEHB after the Advantage plan ends?

You can re-enroll in FEHB if this other coverage ends through no fault of your own.

Is FEHB more generous than Medicare?

Although FEHB coverage can be more generous overall than Medicare Advantage or Original Medicare, having additional coverage may not be helpful if you can’t afford its premiums. If you qualify for the Medicare Savings Program (MSP) or Medicaid, you may find your healthcare costs are lower overall if you don’t use FEHB.

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