Can I Have Medicare And Private Insurance At The Same Time?

Medicare is a very useful program that helps people who are too old to pay their medical expenses, or are suffering from disabilities that make it difficult or impossible for them to work. At the same time, Medicare does not cover as many types of procedures and tests as some of the private insurance plans do. But if you are eligible for Medicare, shouldn’t you be able to have both?

Can You Have Medicare And Private Insurance Simultaneously?

The answer is yes. If you are on Medicare, and you decide to purchase private insurance as well, then you will not lose coverage from Medicare. However, what may happen is that Medicare will become your secondary payer, meaning that it will fill in the gaps that your private insurance does not cover.

When Will Medicare Become My Secondary Payer?

Medicare will become your secondary payer depending on several factors. If you are over the age of sixty five and you are on a Group Health Plan, then Medicare will pay second if there are twenty or more people working for your employer. If, on the other hand, you are on Medicare because of disability, than Medicare will only become your secondary payer if there are a hundred or more people that work for your employer. In either case, if you work for a big company, Medicare will be your secondary provider.

Are There Other Options?

If you don’t want your private insurance company to become your primary payer, you do have the option of Medicare Supplemental Insurance Plans. These are plans that you can purchase to fill in the gaps that Medicare does not pay. What they do and don’t cover is laid out by the federal government, but the rates for the plans vary depending on which company you go through.

17 Responses to “Can I Have Medicare And Private Insurance At The Same Time?”

  1. Arlene says:

    Do these same rules apply to a disabled dependent of an employee (under 65) of a major corporation (thousands of employees)? Can my husband’s company require Medicare to be my primary provider rather than secondary?

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  3. barbara brandt says:

    I received info from Horizon Blue Cross, Advantage Plan with RX. Package makes it clear that they will control not only your doctor choice but have the control to refuse treatments. The huge package they sent after I signed up and was covered, tells me in many many pages, how they will control everything and my options to contest. I have 10 days to cancel my coverage. Tomorrow I am calling to cancel and will cancel officially by certified mail. Seems that the doctor they cover should make decisions and not the insurance company. Just the beginning of the death of Medicare in my opinion so I am staying with Medicare only.

  4. My husband will turn 65 in June, but he’s currently covered under my insurance plan at work, Excellus BCBS. We’re wondering if we even need to consider enrolling for Medicare insurance as long as he’s covered by my health plan. Do we hurt ourselves in any way by not acting on any Medicare coverage now–or whenever it is people nearing retirement age without other coverage need to do so? Also, is it fair to assume that my insurance will continue to cover him, no questions asked, as a spouse of a covered employee?

    • Craig Feied says:

      Regardless of what else you might hear or read, the reality is that he *MUST* enroll for part A medicare, or he will risk a period of no coverage at some time in the future.

      There are *NO* commercial offerings for people over 65 — only supplemental / Advantage policies that require him to have both PartA and PartB.

      I speak from bitter experience, having received bad advice on this same question, and have now investigated this quite thoroughly: if you fall into a gap because you fail to sign up for Medicare and then lose your other coverage without a “qualifying event,” there is absolutely nothing you can do to avoid being uninsured until the next open enrollment (Jan-Mar), with coverage beginning the following June. Depending on the timing, this could mean 16 months during which he is not eligible for any coverage whatsoever.

      For PartB, there is also a lifetime penalty for delaying enrollment when first eligible, and generally the math says he should sign up when first eligible.

      Finally, read the fine print in your benefit plan very carefully. Most (including the most generous plans of which I’m aware) employer coverage (and all COBRA coverage) require that he have Medicare if he’s eligible. Many plans don’t enforce this, but if problems develop they will point to their policy and offer no assistance.

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  6. Sonya says:

    I am disabled and on Medicare part A and B. My husband was now offered insurance from his new job – insurance that offers dental, which is untrue for Medicare. When he lost his privous job, medicare became my primary insurance. Should I continue to use Medicare as primary or should it become secundary? Someone who knows please reply — filling out application for new insurance now.

    Thank you.

    • Jim Frost says:

      It’s a little late but:
      You have no opportunity to choose which insurance is primary, that’s fixed by law. You can decline your husband’s insurance and Medicare then stays as it is.

      If your husband’s insurance will be primary, for example if he works for a large company (ask his HR), then Medicare is secondary, and might provide some extra coverage.

      If Medicare is primary then carefully check terms of the work insurance policy. The work policy may be set up to provide additional coverage only if you have both Part A and Part B. Nothing if you dont.

  7. Rick says:

    My wife have UHC and Medicare. She need to have surgery. What happens if UHC declines payment due to pre-existing condition, will medicare pay.

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  9. Jim Frost says:

    Quirks in the system can effectively eliminate Medicare Part A entirely when Medicare is secondary, especially for a long hospital stay.

    Here’s what often happens. A long hospital stay occurs early in the year, when there have been no claims on the primary. The patient is released and incurs ongiong healthcare costs which the primary pays. Bills arrive from the hospital doctors which the primary pays. Eventually the hospital bill arrives, but the patient’s deducible and other costs have already been satisfied through other primary payments. Patient gets no help through Medicare A.

    Medicare’s attitude, “Sorry,that’s how it works”

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  14. Sue says:

    Can my company ‘refuse’ me company insurance when I am eligible for Medicare –
    I read articles last year where laws were being changed making this legal for large
    companies – but don’t know if it was State or Federal Law being changed.

  15. Eileen says:

    I have health insurance thru my workplace. I also have my husband covered on it . Not happy with that plan,looking for something on my own. My husband is on disability and is automatically enrolled in medicare part “A”. Can he still be on a plan with me ,even if it’s not thru the workplace ? The Ohbahma heathcare website ,told me it’s against the law for them to sell it to me because he has it . But can I purchase it on my own somewhere and keep him on ?