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Insurance & Medicare

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  • Insurance & Medicare

    Just wondering how many of you have group insurance (as primary) and Medicare part B. I don't have part B as of now, just thinking about getting it for my husband. But can't seem to be convinced it would be worth it considering my group policy pays 80/20. What are your thoughts?

  • #2
    Part B pays for doctors office visits, outpatient counseling/psychology, outpatient therapy, and skilled in-home care. A 20% co-pay on these can add up pretty quickly. Generally though if you have Medicare, it becomes your primary and your private insurance your secondary. Have you checked on this?

    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.


    • #3
      Group insurance is primary because I work with an employer who has over 100 employees. David was just in the hospital and thats what they said, I check at as well. It is my understanding that medicare doesn't pick up what insurance left off. I could be wrong, I can't seem to get a straight forward answer on that part.


      • #4
        Mine is that way, w/ Medicare 2ndary. It pics up part or all of the co pays. For instance the copay for my new chair was several hundred dollars, and when she realized she hadn;'t sent it to medicare, it became under $100.
        T7-8 since Feb 2005


        • #5
          Really? That is what started this whole process. David is up for a new powerchair, insurance says our part will be several thousand. They asked if we had medicare part b, I said no but did some research and found that we could start it anytime because he is covered under my policy at work. All we got to do is call and it starts immediately with the next ss check. I even called SS and they confirmed but couldn't tell me what they would pay towards a chair. I further researched the cap amounts for wheelchairs both with my insurance and with medicare. They are both really close together. I think my insurance will pay more. So I will call the dme rep tomorrow and see what he says.