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Thread: Insurance : What happens when you go onto other insurance while you're on medicare?

  1. #1
    Senior Member NW-Will's Avatar
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    Insurance : What happens when you go onto other insurance while you're on medicare?

    Only thinking about this to get a new chair.

    I'm on Medicare/Medicaid. My partner has a good job and could put me on her insurance.

    Could I go on her insurance for a year, get a new chair and then come off her insurance? then go back to just medicare/medicaid.

    How would this effect my medicare/medicaid?

    What other unforeseen things would it mess up for me ?

  2. #2
    Sorry I don't know the answer, but my first thought, if you are getting Medicare AND Medicaid - be very careful in considering this as it may be difficult to get on the Medicaid part again. Can't you use Medicare to get your chair? Yes, may be a lengthy process, but maybe safer path.

  3. #3
    There's probably a clause in her benefits package that says she can't make her policy primary for you since you are eligible for other coverage. If you only had Medicare, her policy might come in as a secondary. But you have Medicaid, too. That's a whole new ball game.

    And in brief, you can't hop off M&M and back on. Medicaid (Apple Health) will want to see all your finances and will be looking not to take you back because it will be documented that you are eligible for private coverage, which gets into household income, assets, etc. Medicare is not very hoppable, either. And the two are intertwined for you.

    Apart from potential eligibility issues, even if you hopped successfully, getting parts/repairs in future years for the chair M&M didn't buy would be dicey. Every DME would have visions of audits dancing in their heads, even if they wanted to play.

    You could easily get caught up in a keepaway match. I would not do it, but I don't think you can, anyway. If your current chair is "too new" for M&M to buy you a new one, I would look to document any major change in your condition/status of the chair that can be documented as necessary and sufficient to get a new chair, or to extensively overhaul what you have.

  4. #4

    Coordination of Benefits System

    Quote Originally Posted by NW-Will View Post
    Only thinking about this to get a new chair.

    I'm on Medicare/Medicaid. My partner has a good job and could put me on her insurance.

    Could I go on her insurance for a year, get a new chair and then come off her insurance? then go back to just medicare/medicaid.

    How would this effect my medicare/medicaid?

    What other unforeseen things would it mess up for me ?
    It sounds like a good idea but you may not be able to get back on Medicare/Medicaid again.

    If you drop Medicare/Medicaid and go on your partner's insurance you would be covered 100%. Getting back on Medicare/Medicaid you would need a "major life event" such as a death, marriage, or divorce to get back on.

    If you stay on Medicare/Medicaid and be added to your partner's insurance your partner's insurance would ask if you are on any other insurance to "coordinate benefits" which means for you Medicare/Medicaid would be your primary or first insurance coverage and if you have any co-pay your partner's insurance would pick that up.

    As long as your on Medicare/Medicaid that is your primary insurance.

    Here's a web site that explains coordination of benefits:

    https://www.thebalance.com/coordinat...nefits-2645754

    I went through the same thing when my wife received medical coverage paid by her employer. My insurance coverage is primary and her's is secondary even though she has a better plan. I had to setup coordination of benefits so everything got billed correctly. I need to keep my insurance as single with my employer as a prong in the fork for retirement, when that times comes.

    Ti
    "We must overcome difficulties rather than being overcome by difficulties."

  5. #5
    Senior Member NW-Will's Avatar
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    Thanks for the input.. I figured as much.
    Was kind of hoping you'd be able to arrange the priority of the insurance, without going off medicare/medicaid etc.
    So my primary would be my partners insurance, and then medicare/medicaid etc.

    Yeah. The chair my PT is spec'ing for me the DME's are pretty much not willing to run through the insurance as their isn't enough profit for them etc.

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