Primary Insurance

[steveadlman]

My client is enrolled in Medicare A and B and has a Medicare Supplement plan. Medicare still shows that his employer plan (Blue Cross), where he retired from, is still primary. Is it up to Medicare to remove Blue Cross as his primary insurance, or does he need to call Blue Cross to communicate with Medicare that he is no longer covered under their policy?

 

[TNPhil]

I'm glad you asked this question. I also have a client in the same situation. She contacted Medicare and they told her they couldn't change her primary to Medicare and secondary to Aetna...which makes absolutely no sense to me. Her bills are still being sent to BC/BS employer plan and they are of course denying them. It's a nightmare, hopefully someone can shed some light on how to resolve this situation

 

[vic120]

Oh wow I have not run into this for 8 years

However it used to happen a lot, There was a specific number to call Medicare and fix this, I had it at the time, It was before I moved to TN, I used to have it on my wall was a specific department

Haven't needed it though since I have been here I forgot the details Dept name and such

 

[Travis Price]

So, call Medicare BRCR at 1-855-798-2627 to update primary insurance information.

Remember, if client has a retirement plan, Medicare pays first, retirement pays second. If it's an active employer plan with more than 20 employees, Medicare pays second, emp pays first.

PS: Not meant to be rude or disrespectful, but a Google search for "reporting changes in Medicare coverage" answered the question in 5 seconds. Just saying it's faster to research the answers yourself.

 

[kgmom219]

Sigh.

Calling BRCR is not going to help, they can't change that info.

Step 1: Confirm client is termed with former coverage.
Yes-BCBS needs to send info to Medicare
No-Client goes to former employer and gets them to term the coverage

Step 2: Once the info is sent to Medicare, the claims have to be re-filed. That's when BRCR can help.

In the interim, let any provider know who needs payment what has happened and until the former employer tells BCBS to tell Medicare, you are stuck and need 90 days of grace.

 

[kev_60]

Thanks kg. As I said Travis my client tried calling Medicare and was told that would not change anything. i have advised her to contact BC/BS and ask them to get in touch with Medicare asap.

 

[kgmom219]

Thanks kg. As I said Travis my client tried calling Medicare and was told that would not change anything. i have advised her to contact BC/BS and ask them to get in touch with Medicare asap.

If BCBS still shows them active, they cannot help. And depending on the BCBS and when they do the crossover, it may be a few weeks, as many as 5. Not kidding. I would warn the client. This is not an overnight fix and if he is getting bills, he needs to let the docs and providers know ASAP what is going on.

 

[somarco]

Jenny is correct. BX has to drop the retiree from the group plan and notify Medicare.

This happened to me . . . covered under wife's plan until 65 . . . wife told HR to drop me as of X date . . . which they never did even though they did not collect premiums on me. I didn't know I was still on group plan for probably 6 months when I had my first claim.

Wife had to handle it with carrier since she was the employee and I was the dependent.

Medicare will not change their records to show them as primary until the group carrier notifies them that the covered participant is officially dropped from the plan.

I ran into this a few months back with a client so I know it still goes on.

Even after their records are changed your MyMedicare account may still show the group plan as primary. It could take 60 days or so to effect the change.

 

[DS4]

You need to call Medicare. Speak to the Medicare Secondary Payor Unit.
Coordination of Benefits & Recovery Overview | CMS

 

[steveadlman]

So, call Medicare BRCR at 1-855-798-2627 to update primary insurance information.

Remember, if client has a retirement plan, Medicare pays first, retirement pays second. If it's an active employer plan with more than 20 employees, Medicare pays second, emp pays first.

PS: Not meant to be rude or disrespectful, but a Google search for "reporting changes in Medicare coverage" answered the question in 5 seconds. Just saying it's faster to research the answers yourself.

I had two clients call the Medicare BCRC phone number and successfully get their Blue Cross group health plan removed as their primary insurance and replaced with Medicare as primary.