Why do I have to have Part A Medicare when I already have private insurance?

2 answers | Last updated: Sep 18, 2016
A fellow caregiver asked...

I am 49 years old and receive disability I have told both Medicare and Social Security that I do not want any of the services that Medicare provides Part A, Part B or Part D. I was told by a Social Security Rep that I have to have Part A in order to continue to get my disabilty. I feel that this is unfair because I have both health and hospital insurance through my spouses employer. Why do I have to have Part A and will it effect my other insurance coverage? That is my greatest concern I don't care that it is free I don't want it at this time because I don't need it

Expert Answers

Barbara Steinberg is the CEO and founder of BLS Eldercare Financial Solutions, which specializes in helping families pay for long-term care for their loved ones. A registered financial gerontologist, she speaks regularly on the topic of paying for long-term care and is a financial expert for Caring.com.

Since you receive SSDi, you are required to be covered by Medicare Part A. You are also covered by your spouse's employer plan. These coverages work together without duplication. Depending on how many employees there are in your spouse's company, Medicare will either be primary or secondary. If there are less than 100 employees, it will be primary. If there are 100 or more employees, the employer plan will be primary and Medicare will be secondary. If you should need to use your coverage, the primary will pay first. Then, if there are any unpaid expenses, the secondary will usually pay for them. For example, if you have copays or deductibles with the primary, these can be reimbursed by the secondary. Working together, you have 100% coverage. You cannot get more than this.

Community Answers

Grannyj3 answered...

My husband worked in the home office of a huge insurance company in Des Moines IA. As surviving spouse I have my medical coverage and also Medicare. Medicare has ALWAYS been primary; consequently my private insurer pays almost nothing. There is no reimbursement or coverage for copays or deductibles. If this is wrong how do I get it fixed? Please!