Making medicare primary while still employed, is there a way? - AgingCare.com

Making medicare primary while still employed, is there a way?

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My mother is still an "active" employee, she has a government job. They said her medicare will not be primary until she is not active however her disability retirement paperwork takes a few months to process. I filed her ssdi paperwork through a lawyer and should be done quickly. She has end stage renal failure (among other things) and is currently on dialysis. I know she had medicare as primary after her kidney transplant in 2001 for 5 years. Is there another way to get medicare primary while still an active employee? Hospital wants to transfer her to the nursing home rehab and as long as her empire is primary they wont cover but if medicare is primary empire will pick up. Any advice would be great. Thanks!

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my mom is 70 years old and want to go back working part time she cant live on ss alone also she has sliding Medicaid what and whom does she have to call to go back to
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I have worked for doctors doing insurance billing and it is my understanding that as long as your Mom is employed and has insurance provided to her through her employer, that insurance is her PRIMARY and Medicare is her secondary. I do not believe there is any way around that.

If your Mom is in End Stage Renal Failure I have to wonder why she is still working. Is she trying to get in enough time to be able to retire with benefits/pension?

I am on Disability myself and Medicare is my Primary carrier, however I do not have an employer.

You can call Medicare but it is my understanding that as long as she is employed Medicare will not be her primary, I don't care if she is 80. She may need to quit her job. Being this ill, she may not be able to go back to work anyway.

God Bless All of You!!!
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OH--about Part D:
When one gets on Medicare, it's imperative to get signed up on a Part D Plan, right away, UNLESS one has a "creditable coverage for pharmacy" thru work insurance or other insurance.
NOT V.A.--veterans administration medical/pharmacy is not counted as "creditable".
The longer one waits to have Part D, or at least a Creditable coverage,
one gets assessed additional fines each month, which result in paying more for meds, forever after.

Some renegades simply refused to have any insurance but their Medicare, & refused to get Part D at all, figuring they are healthy, & don't need it, can't afford more than that.
If one chooses to do that, I highly recommend they also do NOT own any assets, or they will lose them to pay for whatever medical they can't pay for later.

One friend did this; she made those decisions when she was doing pretty well; figured, she'd probly die before needing medical. No amount of argument would change her mind.
She ended up needing bilateral hip replacements only a couple years after that decision....there is substantial medical care and meds needed.
She will either lose her home, if she hasn't already, and end up being dependent on others--I know that will rankle that free spirit!
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As far as I know/been informed,
one cannot get Medicare as primary unless they are retired/on SSI or SSDI, and have no other insurance as primary.

As long as one has insurance thru their job, that is primary.
State welfare [Medicaid], and Federal [Medicare], refuse to be primary until after the work insurance goes away.
Insurance is charged for expenses in this order, IF one has access to all of them:
1st is work insurance or private insurance;
2nd is Medicare;
3rd is Medicaid.

If someone goes out on medical leave from work, their work insurance continues for a specified period of time, during which it is still primary.

Her job may keep her on their books as employed, both for a certain specified period of time, often 30 days to 60 days; also, time may get extended because she may have accrued leave time/vacation time, etc., which can extend length of time her work insurance stays active as her primary.
How accrued leave time adds up, can be generous, depending on the government job one is in.

When SSDI kicks in, if she still has leftover leave/vacation time, she might opt to cash-out, if that's allowed, to shorten the time her work insurance is actively primary---then as soon as the work insurance stops, her medicare becomes her primary insurer...
BUT...
With her conditions, she may wish to sign up for a Medicare Advantage Plan, which incorporates her Medicare, & enlarges what is covered to some extent.
Some plans are better than others. Many are HMO's. Some have various cost plans.
They all pretty much cover more than Medicare alone.
Only, Advantage Plans don't travel very well....if one travels, and needs care, one MUST access care via an E.R., never a clinic or Docs office--or the Advantage Plan refuses to cover.
These usually automatically contain a Part D coverage for pharmaceuticals.
Part D is required--the sooner one signs up for one, the better, to avoid penalties, if their plan lacks one.

A "Supplemental" OTH, is an additional plan, that covers some costs over and above what Medicare alone covers---these are separate from Medicare.
AND, one usually needs to find a separate Part D Plan to go with these.
Supplemental Plans usually travel nicely just about anywhere Medicare does, across the Country--you may need to go to their choice of practitioners.

Sometimes, a worker is injured or ill, & can file early to get access to Medicare. They must apply to get SSDI for that.
It is unusual for someone to continue working when disabled,
but it can happen.
SSDI income reverts to SSI once one reaches regular retirement age.
Usually, the monthly stipend decreases at that time, because you have not been contributing to Social Security, because of not working.
BUT, if one is able to keep contributing to Social Security by working some while on SSDI, that keeps feeding the Soc. Sec. fund, which means your monthly stipend should stay fairly similar to the SSDI stipend, once you reach regular retirement age.

Some persons who are deemed disabled, are placed directly on SSI.
I have yet to figure that out, or what that means to the recipient, other than they get a smaller stipend. The still get Medicare, and may qualify for Medicaid help, too.
If someone is under-income, they can contact DSHS to get placed on the Federal Program that DSHS manages, to make the monthly payment for Medicare, instead of it being deducted from their SSDI /SSI checks. That should also cover paying for their Part D Plan premium, I think, unless the Part D is part of a package plan.

But the rules for Medicare & Medicaid stay consistent, as above described, as far as I know.

It's kinda late--I hope that made some sense!
.
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Yes, CarolLynn, you are correct. Both come from our government as income.
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Huh? I thought SSDI now and "Social Security Disability Insurance and that SSI refers to "Supplemental Security Income" ??
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I am sorry I mixed up the acronyms - SSD or SSDI - depending on your disability and state is the Medicare social security disability insurance. SSI is if you are receiving social security insurance but are not on Medicare yet but will be eligible when one turns 65 yrs. It might be called Medicaid in your state. In my state it is AHCCES (or access - I might be a wrong about the exact acronym). Anyway, with your mom's ESRF her primary insurance will pay for hospitals for 30 months then Medicare will coordinate and take over as primary. For further info you can go to medicare.gov. I have my own account so can ask questions about my particular coverage. Good luck!
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My mother was working up until may 23rd when her job sent her to the ER. She was in renal failure (again - had 2 transplants last one in 2001 which she was on dialysis for 6 years prior and worked through out). She ended up having emergency surgery due to an unrelated problem. she had diverticulitis and had a flare up and ended up with a hole in her colon and bowel in her abdomen. She had sepsis and is still recovering but almost there. She is an amazingly strong woman who has been sick her entire life and never took hand outs. She is not able to move much because she has been in bed for 12 weeks. They started dialysis a few days after her surgery because her kidney was done, she was not on dialysis before but preparing having the fistula put in her arm and waiting til her levels werent good. She has Empire BC/BC through her job. All of the agency I communicate with refer to social security disability as ssdi. She is not working but still remains an "active" employee until her disability retirement is approved.
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I am totally confused. You say your mother is working, yet you mention she has end-stage renal failure, is in the hospital, hospital wants to send her to rehab and I have no idea what "empire" is. As a nurse, I need clarification. I have social security disability (NOT SSDI - that is not the correct term), and am on Medicare and have been since 2001, even though I am not yet 65 yrs. So, I going to assume the government job she has (whatever that is) is primary until she quits or retires. Then Medicare will become primary. I don't understand with a diagnosis like she has how she is still able to hold a job. End stage renal failure is terminal. One cannot live without kidney function. My best to you both.
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