I am on disability and on medicare. I'm also covered on my husband's insurance. Who is the primary insurance?

Question

My husband's plant has less than 100 employees. If you go by this then medicare should be primary. But my husband's plant plus other plants under the same name are all subsideries of Spencer Wright Industries, Inc. According to Medicare that means they have more than 100 employees and my husband's insurance must be my primary insurance. My husband's co. doesn't agree, so none of my medical bills are getting paid. It's a constant fight to get any medical claims paid. Does anyone have any facts or proof that my husband's plant is trying to use a loophole to get out of being my primary insurance provider and getting medicare to pay first? How can I get my bills paid when i go to the doctor or hospital?

Answer 1

The size of the company, not the plant he works at, determines the number of employees - thus, Medicare is correct. However, husband's insurance should be billed first, medicare second, and re-submit husband's insurance until they pay - many times when medicare is secondary they have the policy to automatcally reject the first and second submission.

Answer 2

Call the medicare toll free number on the back of your medicare card and tell them you want to file a formal complaint because you have been denied coverage even though you are on Social Security Disability and are eligible for Medicare. I am assuming that you have been on Social Security for 18 months and have been assigned a Medicare card. If not, then your husbands insurance must pay. Also you will need a supplement to cover what Medicare doesn't pay. Commonly referred to as a medigap policy. I was an insurance broker prior to retirement

Answer 3

every state has its own policy however in california medicare is primary and ur husband's ins is secondary... in order to get this resolved u must find out the state laws where u live... secondly if u have insurance then u have nothing to worry about... when u get a drs statement simply mail in a copy of both ur cards and ask the office to bill ur insurance. they will find out who's ur primary and secondary and do all the hard work themselves... trust me i do this 8 hrs a day 5 days a week ... unfortunately... lol... but yeah stop worrying urself between both ins u should have no bills to worry about i would suggest calling the drs billing office to check up on ur account from time to time but most medicare charges take up to 6 months to get paid. good luck

Answer 4

I used my hubby's coverage from artwork, till he became disabled, too. luckily, that became previously section D kicked in, so I wasn't penalized for no longer having my own medigap coverage on correct of the Medicare. yet, you ought to get some medigap no your own. First, it really is in all probability to be more inexpensive then if hubby has to comprise you in his coverage, and 2d, i desire you both stay lengthy adequate that your hubby retires sometime and needs his gained medigap to fill in the gaps of Medicare. yet you would possibly want to no longer comprehend what medigap skill. it really is an coverage plan that covers most of the gaps Medicare would not cover. i have by no skill heard of Coventry, yet i'm getting my medigap through a subdivision of Blue bypass. maximum coverage plans gained't cover disabled human beings in Philadelphia (too many Philadelphians overuse their coverage already, so very few for-earnings company needs to probability masking someone like that who's likewise disabled.) So examine into coverage plans that cover you as a Medicare recipient. they're about 20% of the fee of shopping for comprehensive well being coverage on your own as a healthful individual. That way, you do not ought to agonize if hubby has you lined or no longer, you get to save your own medical doctors, and also you're literally not left scrambling, if he turns into unemployed on an same second you've a well being disaster.

Answer 5

Your husband's insurance is the primary and medicare is the secondary unless your husband is retiree and covered by his company's insurance once he worked for. He is now working for the company which give him health insurance and you are covered by the insurance as his dependents. Then definitely your husband 's insurance is the primary for you.

Answer 6

Ask your husband's carrier to decline to pay the claim in writing. Forward the declination to the Medicare office, and ask THEM to respond, in writing, to both you and the other insurance company.

I strongly suspect you're right - but I also strongly suspect they haven't put anything in writing yet, and as soon as you ask them to, things will start getting paid.

Answer 7

if you ARE NOT working, medicare is your primary and your husbands is secondary.

if you ARE working, it is the other way around. i do this every day at work

Answer 8

I believe it is medicare. Call them to find out. They will be able to tell you.

Answer 9

your husbands ,,,have him drop you and let medicare pay for it, you paid taxes for this purpose

Answer 10

Your husband's.