When it comes to health insurance plans, there are generally two options you can choose from. One is a Medicare health insurance plan, and the other is individual health insurance provided by private companies and agencies. However, you can have both the private individual health insurance and Medicare health insurance offered by the government at the same time. For example, if you have private health insurance already and turn 65 to qualify for Medicare, you can keep both health insurance plans. However, many people are not sure how Medicare and private health insurance work together and how it is possible to have both at the same time. This is why, in this article, we will help you understand how you can have Medicare and private health insurance simultaneously, so keep reading.
How Does Medicare Work With Private Health Insurance Offered By Health Insurance Companies?
Now that you know it is possible to have private health insurance and Medicare, the next question that pops into the mind is, how do both insurances work together? In case you have both Medicare and Private insurance from health insurance companies, both types of insurance work based on a regulation called “coordination of benefits.” The coordination of benefits decides which health insurance will pay for healthcare expenses first. Usually, the primary payer covers the cost of a healthcare service until it reaches its limit. Once the primary payer has reached its coverage limit, the secondary payer kicks in and pays for the cost that the primary payer doesn’t cover.
The primary and secondary payer is determined based on your private health insurance plan and your case. As per some private health insurance, your Medicare plan will pay first, while other private insurance plans set your private health insurance as the primary payer. Your doctor’s office can usually help you determine this if your insurance agency has not made this clear.
What are some situations where you can use Medicare and private health insurance at the same time?
When you have both Medicare and private health insurance plans, it is usually under the following circumstances:
When you already have group health insurance from your employer: When you already have group health insurance provided by your employer, and you turn 65, you can get Medicare along with your group health insurance. So as you turn 65 and sign up for Medicare, your Medicare health insurance will become the secondary payer, and your group health insurance becomes the primary payer in most cases.
When you have retiree health benefits:
Employee unions or former employers offer retiree healthcare coverage. You can avail of Medicare along with retiree health benefits, and in such cases, your Medicare plan becomes primary payer, and your retiree coverage becomes secondary payer. In short, your retiree health benefits plan becomes a supplementary insurance plan on top of the Medicare plan and covers costs that Medicare does not cover. This combination is a great way to get affordable health insurance for yourself after you retire.
When you have coverage under your spouse’s private health insurance: This is one of the most common scenarios where you might have both Medicare and private health insurance. When you already have healthcare coverage under your spouse’s health insurance, you can enroll in Medicare when you turn 65. You can enroll in Medicare Parts A, B, D, or even Part C or enroll only in Part A when you already have your spouse’s private health insurance coverage. You can also delay the Medicare coverage until your private spousal insurance expires.
If you would like more information regarding Medicare and Medicare Supplement Plans, there are companies like The Benefit Link that offer free of charge consultation.