Drop Medicare Post Transplant (early)?

[iolaire]

Does anyone know if you can drop Medicare post-transplant prior to the 36 month post-transplant coverage end date for immunosuppressants?  I guess I’m asking if other insurance plans will require that you maintain the Medicare coverage?  I have strong employer based coverage and pay a huge amount monthly for Medicare.  It would save me a lot if I was to be covered only by my employer provided insurance.

[cattlekid]

I was in the same boat and I wish I could tell you that I was able to drop Medicare.  I hated having Medicare, I had to pay for both Medicare and my employer insurance to cover my husband.  My employer insurance covered NOTHING for me while I was on Medicare because Medicare paid more than they would have done.  So they were just there to be the backstop in case something hit the fan and I had to start racking up the big bills.  Meanwhile I was paying for two insurances plus still having to cover the 20% that Medicare did not pay.  I get why Medicare is there for those that need it but I think that for those of us who are younger and have good employer insurance, we should be able to sign a Medicare waiver.

[cattlekid]

Oh, I realized I did not answer your question.  No, I could not drop Medicare because once the 30 month coordination period was over, my employer insurance stopped paying all of my claims as primary.  They knew the minute that 30 months was up and they were more than happy to shove me over to Medicare for the three years after my transplant.  Believe me, I was counting the months to go back to my regular employer insurance.

[iolaire]

Thank you for your answers.

[robertscz]

I'm confused... I just have employee insurance, very good and they have been covering all my Dr Apts ect and are going to pay for the transplant... After the transplant I was under the assumption that my employee insurance would just continue to cover the immunosurpressent? Am I incorrect in this? I don't need to be surprised by something after the fact.

[iolaire]

After three years on dialysis you are forced to be on Medicare and its primary. So if you are on Medicare because of dialysis it will be primary at transplant and will continue for three years. Medicare without a drug plan will still pay for immunosuppressants.   The more you earn the more you pay for Medicare.

[PrimeTimer]

I don't know but I'd think that your employer plan will want you to keep Medicare as your primary (and them as the secondary) for as long as you are "Medicare eligible". Simply put, the employer plan probably doesn't want to pay for anything they don't have to. I remember my husband's employer plan leaving him a snotty voicemail once he was eligible to have Medicare pay the bulk of his dialysis treatments as the primary payor. They said they knew he was Medicare eligible and that Medicare should be the primary and if not, he needed to send them (his employer plan) a certified letter stating WHY he was not eligible for Medicare. Insurance companies seem to be very keen on the laws and what they have to pay and not pay. But they are also fairly quick at paying their share whereas Medicare is extremely slow and months and months behind.

[cattlekid]

That was one of the other complaints I had with Medicare.  My employer insurance (Blue Cross Blue Shield of IL) paid the day after a claim was submitted if it was submitted electronically.  Also, their website was easy to understand with a good user interface and if I had to call them, everyone was knowledgeable and friendly. 

Social Security Administration/Medicare on the other hand?  Interminably long wait times on the phone, get a different answer every time you call. They lost one of my payments so I had to loan the SSA an extra $700 for months while they tracked the payment down.  I kept apologizing over and over to my different providers telling them that I had to be on Medicare so they were going to be paid slowly as I wasn't going to pay my share until Medicare paid.  And their website was complete garbage from a user experience standpoint. 

I guess if I didn't have such stellar employee insurance, I would have been happier on Medicare.  But at the time, it was a definite downgrade.

Insurance companies seem to be very keen on the laws and what they have to pay and not pay. But they are also fairly quick at paying their share whereas Medicare is extremely slow and months and months behind.