Tuesday, March 2, 2010

Re: The Plan wording

Question
Hi John,



Thank you for your responses to my questions regarding  enrollment in Medicare A &  B . You said to read my current UHC plan carefully and the following  paragraph have me confused as to whether UHC PPO plan will or will not remain my primary.





D. The first of the following rules that describe which COVERAGE Plan pays its benefits before another coverage plan is the rule to use-

1. Non Dependent or Dependent. The Coverage Plan that covers the person other than as a dependent, for example as an employee, member, subscriber or retiree is primary and the Coverage Plan that covers the person  as a dependent  a secondary. However if the person is a Medicare beneficiary, and as a result of federal law, Medicare is secondary to the Coverage Plan covering the person as a dependent and primary  to the Coverage Plan covering the person as other than a dependent (e.g. retired employee)then the order of benefits between the two coverage Plans is reversed so that the Coverage Plan covering the person as an employee, member, subscriber or retiree is secondary  and the other Coverage Plan is primary.  


Answer
Hi again.



That would confuse anyone.



Working person:    plan first====Medicare 2nd

    spouse        plan first====Medicare 2nd



Neither working    Medicare first=====Plan 2nd

=====================================================

Both working====on each others plan

 Husband==his first===hers 2nd===Medicare 3rd

 Wife====hers first===his 2nd===Medicare 3rd



John