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  • Author photo Lisa Mims
    Lisa Mims in Coverage | 3025 Reads
  • 04/05/2022

Job-based insurance when you are disabled - Job-based insurance and Medicare Part 2

From Medicare Interactive

Job-based insurance is insurance offered by an employer or union for current employees and family members. job-based insurance allows you to delay Medicare enrollment. However, yo may want to enroll in Medicare depending on whether your job-based insurance pays Primary or Secondary. In most cases, you should only delay Part B if your job-based insurance is the primary payer (meaning it pays first for your medical bills) and Medicare is secondary.

If you are eligible for Medicare due to a disability (meaning you are collecting Social Security Disability Insurance) and are covered by your, your spouse's, or in some cases a family member's job-based insurance, you have a Special Enrollment Period (SEP) to enroll in Part B up to eight months after you no longer have coverage from current work. This means that you are not required to enroll in Part B when you first become eligible for Medicare (but you MUST have Part A to keep SSDI). However, remember that i most cases you should only delay Part B enrollment if our job-based insurance is the PRIMARY payer.

-- Job-based insurance is primary if it is from an employer with 100+ employee. Medicare is secondary in this case, and some people choose not to enroll in Part B because of the additional monthly premium.

-- Job-based insurance is secondary if it is from and employee with fewer than 100 employees. Medicare is primary in this case, and if you delay Medicare enrollment, your job-based insurance may provide little or no coverage. You should enroll in Part B to avoid incurring high costs for your care. >> If you have job-based insurance from a family member and Medicare is primary, you do not have a Part B SEP. You should enroll in Medicare as soon as you are eligible to avoid penalties and gaps in coverage. << -- NOTE: THERE ARE DIFFERENT RULES IF YOU ARE MEDICARE-ELIGIBLE DUE TO AGE OR BECAUSE YOU HAVE ESRD.

To find out if your job-based insurance is primary or secondary, contact your or your spouse's human resources department. If you plan to delay enrollment into Part B and use the SEP later, keep records of our health insurance coverage. you will be required to submit proof of our enrollment in job-based insurance when using the SEP to enroll in Part B. Proof of enrollment in job-based insurance includes: -- Written notice from your employer or plan -- Documents that show health insurance premiums paid, including W-2s, pay stubs, tax returns, and/or receipts -- Health insurance cards with the appropriate effective date

NOTE: If you have another form of insurance from your employer, like COBRA or retiree insurance, there are different rules for how Medicare works with your plan.

medicare insurance coverage work coverage spouse medical pay first Disabled #48
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