Medicare or Private Insurance?

My brother is younger than his wife.  His wife has Medicare but he's still carrying health insurance for her. He wants to know if he can drop her from his health insurance?  Do all health insurance companies automatically terminate a spouse when he/she becomes Medicare eligible?

Answer:

It depends. Is his health insurance the "primary" payer for her medical expenses? If so, he should continue to carry her on his health insurance, but be sure to submit any allowed expenses to Medicare after his health insurance has paid as much as is covered.

Medicare Secondary Payer is the term used by Medicare when Medicare is not responsible for  paying your health claim first. (Your brother's private insurance company will likely talk about Coordination of Benefits when assigning responsibility for first and second payment of a health claim.)

If his wife's primary coverage is now Medicare, then he should check and see if it makes sense to continue to have her on his health insurance. If the cost of his insurance is more than what he would likely submit in claims, he should drop her coverage.


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