Making Medicare as a Primary Insurance - Advanced Prostate...

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Making Medicare as a Primary Insurance

JoelT profile image
10 Replies

Has anyone had any experience with what insurance is primary if they have medicare and their spouse has a policy through her work place?

Joel

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JoelT profile image
JoelT
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10 Replies
bhammel profile image
bhammel

Medicare is primary.

Ca-Darrell123 profile image
Ca-Darrell123

I have used my wife's insurance as my primary and medicare as my second insurance for the past four years. We upgraded my wife's insurance to a PPO and we virtually have not had to pay a copay for any procedure once we reached the max family expense of $2500 for the year.

in reply to Ca-Darrell123

I have Medicare as primary and I'm on my wife's policy as the secondary. So far so good with few out-of-pocket expenses (for scans, radiation, Lupron, MRIs). The secondary issurance is covering most of the cost of Zytiga through CVS specialty pharmacy; don't know what will happen if my oncologist wants to try Xtandi after Zytiga fails (my PSa is rising).

JoelT profile image
JoelT in reply to

Steve, I can tell you that at this time CVS will NOT pay for the Xtandi. You need to join us and contact CVS as I suggested and object. It is best if you would send an email and make a phone call. We are trying to make CVS take heed and pay a price for this decision.

Next week I will be launching a next step to our protest. CVS needs to understand that this decision has a human cost.

Please, if you are willing forward a copy of your email to the Malecare ED at Darryl@malecare.org

Joel

arizonablue profile image
arizonablue

I was informed by Medicare that when your wife or husband is working and has insurance and you are on the insurance as the secondary Medicare has to be the back up to your wife/husband's insurance?

I think your medicare is primary if your spouse has other insurance but is retired. I made the mistake of continuing being covered by her despite my reaching medical age. It would have been cheaper if I had just gone on Medicare at age 65 and dropped her coverage of me.

Dan59 profile image
Dan59

Nalakrats , I thought that was a caveat of obamacare and all insurance is that they could not refuse you for preexisting condition?

yope4 profile image
yope4

I'm on Medicare with Cigna (carried over from work after retirement) as supplementary. I reach my maximum copay within half-year and the rest is free. All my PCa meds come from UVA where I get treated and so I don't have any issue. I'm thinking if you go to an institution (like a University hospital), you can get prescribed by your doc there and obtain your meds through the university pharm.

I just signed up for plan F with AARP UnitedHealthCare. This was an upgrade from last year's HMO type plan also with AARP UnitedHealthCare. Despite being diagnosed last year with prostate cancer I was quickly approved for this plan. When I signed up last year I had no health concerns and took the cheap plan. This year I know better and want the option to see specialists without a referral. I think thinks will work out well. I recall in the application process that they were keen on knowing whether you were on dialysis or not. That seemed like the only discriminator I could see.

jmurgia profile image
jmurgia

The "Welcome to Medicare" brochure outlines the circumstances under which Medicare is primary or secondary. (CMS Product No. 11095) Google "Welcome to Medicare brochure".

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