- April 9, 2024
- Posted by: legaleseblogger
- Category: Related News
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## Situation of Disabled Government Retiree with Retiree Health Insurance
My mother, a disabled government retiree, has been facing a sudden financial burden regarding her health insurance. Despite already paying approximately $180 a month for her retiree health insurance, which is a UHC Medicare Advantage plan, she received a letter informing her that her state will no longer cover her Original Medicare Part B premium of $174. As a result, she will now be responsible for this additional cost on a monthly basis.
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She can’t have a Medicare Advantage plan if she’s not enrolled in part B.
No. She can’t rely on her retiree health insurance alone. They only pay claims after Medicare pays. I am a retired fed and I have to pay for both Medicare and BCBS for federal retirees. Why did the state stop paying her Medicare premium?
Everyone on Medicare Advantage is still responsible for the Part B monthly payment. Some Advantage plans kick that back to the insured, most don’t. But if she has Advantage, she’s not on original Medicare.
Over age 65 Medicare is required. Medicare advantage plans require subscription of Medicare Plan B. That premium is auto deducted from monthly social security check. $174 and some change. Now come October you can shop for new advantage plan that meets your needs in cost and coverage. All depends on zip code you live in.
No that’s not how that works. The Medicare is needed to go with the advantage plan-that she pays $180 for (but probably sees some give back from, usually you get so much money back with the advantage part). Parts A&B have to be kept to get any of the help from the advantage plans so it’s maybe see if the state will help again pay for it in the future (by applying for the “extra help” through medicare). She can’t use anything to do with an advantage plan without the actual insurance that provides/gives the advantage plan being a part of the insurance-you can’t get a Medicare advantage plan without first having the Medicare (part b premium being paid) to get the advantage plan from.
I highly recommend the you tube channel MedicareSchool.
The presenter details exactly how Medicare A, B, Medicare Gap insurances (D RX drugs, F gap insurance (only available to those born prior to 1950, G gap coverage) and Advantage plans which are distinctly different than the gap plans.
Because she was a disabled government retiree her coverage will change when she reaches her full retirement age. Being a retired government employee who may not be eligible for Social Security retirement benefits due to the windfall protection legislation means that the her part B is directly billed to her. Thus she must pay for Part B.
It is important for her to understand the six gaps in Medicare coverage and the difference between an Advantage plan versus a gap plan, when she she can change her Medicare supplemental plan coverage, the true costs in regards to premiums, penalties for not having B or D coverage and out of pocket costs.
Remember the Advantage plan is supplemental to A and B, it does not replace A and B.
Before changing or dropping coverage you need to have a firm understanding of both the benefits and detriments of what ever supplemental plan your mother chooses. And understand that Advantage plans do not replace A or B.