AboutJohn Pedit Expertise Am an expert on Medicare, Medicare HMOs, and Medicare supplemental insurance. Also have extensive knowledge of Medicare especially in Mich. Have knowledge of COBRA and the Portability Act
Experience
Past/Present clients Council about 300 persons yearly and do many presentations on Medicare
Question Our member is actively at work under age 65 for a group of more than 100. Her spouse is retired under age 65 with medical benefits through his former employer and he has Medicare Part A due to disability. Since he is under age 65 is his retiree plan primary then Medicare and then the wife's health plan?
Please advise
Answer Hi Ann
Hard to tell. Normally it would be his plan, then hers, then Medicare. But the commercial insurances have wised up and have begun putting restrictions on their coverage. In October, her plan and his should be sending letters to them and the letter will contain any restrictions that they have. Some plans have already sent the letters. So to get the real answer it is necessary to compare the letters they get for any restrictions.
There is also the possibility that his retirement plan is a Medicare Advantage plan paid for by his former company which might effect the arrangement. After they have received the letters, call the Coordination of benefits unit of Medicare, 1-800-999-1118 and see what information and order of pay is on the master file.
