{"id":7136,"date":"2020-01-02T12:05:10","date_gmt":"2020-01-02T17:05:10","guid":{"rendered":"https:\/\/peakinsuranceadvisors.com\/?p=7136"},"modified":"2024-03-06T12:36:18","modified_gmt":"2024-03-06T17:36:18","slug":"medicare-and-small-business-health-insurance-coordination-in-ny","status":"publish","type":"post","link":"https:\/\/peakinsuranceadvisors.com\/medicare-and-small-business-health-insurance-coordination-in-ny\/","title":{"rendered":"Medicare and Small Business Health Insurance Coordination in NY"},"content":{"rendered":"
Medicare Estimation is a process for determining the secondary payment when Medicare Part B is primary, and the member has not enrolled in Medicare Part B. Medicare Estimation reduces the payment by the amount the primary Medicare Part B would have paid if the eligible member was enrolled. This amount is not covered by the fully insured plan. Remind your impacted members to consider enrolling in Medicare Part B.<\/p>\n
Applicability<\/strong><\/p>\n Medicare Estimation applies in any of the following scenarios:<\/p>\n The reduction is permissible under NY rule 11 NYCRR 52.23(l). Our process applies to Medicare-eligible members who have Medicare Part A, but not Medicare Part B, and Medicare is primary. Should a Medicare Eligible employee stay on a Group Health plan?<\/strong><\/p>\n If you consider that Medicare eligible employees should now have Medicare parts A and B, wouldn\u2019t it make more sense to have the employee take out a Medicare Supplement<\/a> and prescription drug plan? The employer might even agree to pay for the premiums for these plans on the employee\u2019s behalf. The overall savings to the employer in premium dollars, and the usual increase in benefits to the employee in lower out of pocket costs and no restrictive doctor network usually make this scenario a good option for both Employer and Employee. You should seek your own tax advice from your tax professional on tax deductibility for this scenario. We can assist in Medicare Supplement and Part D Rx insurance from United Healthcare AARP if you complete this quote request.<\/a><\/p>\n In summary, it is best to at least have Medicare Eligible employees understand that even though they are not required to have Medicare Part B, they are leaving themselves open to potential catastrophic medical bills if they don\u2019t plan ahead. You might even insist they sign an acknowledgement to that affect.<\/p>\n James Eckardt is President of Peak Advisors in Holtsville NY. Peak Advisors specializes in affordable small group health insurance, Business Insurance and Senior Insurance products.\u00a0 Peak Advisors will assist you in comparing, obtaining, and servicing all your New York business insurance needs. They have been providing low cost, high quality health insurance benefits for 30 years. Visit their\u00a0small business health insurance page<\/a>\u00a0to find all of the current rates for small group health insurance plans for NY businesses.<\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Medicare and Small Business Health Insurance Coordination in NY Medicare Estimation is a process for determining the secondary payment when Medicare Part B is primary, and the member has not enrolled in Medicare Part B. Medicare Estimation reduces the payment by the amount the primary Medicare Part B would have paid if the eligible member […]<\/p>\n","protected":false},"author":5,"featured_media":7147,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"mc4wp_mailchimp_campaign":[],"footnotes":""},"categories":[411],"tags":[2222,2223,2225],"class_list":["post-7136","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medicare","tag-medicare-and-small-business-health-insurance-coordination-in-ny","tag-medicare-estimation","tag-medicare-estimation-and-coordination-with-group-health-insurance"],"yoast_head":"\n\n
\nof Medicare.<\/li>\n
\nMedicare Estimation does not apply in these scenarios:<\/li>\n
\nactual amount Medicare paid.<\/li>\n
\nThe process is described in the member\u2019s certificate of coverage. For your reference, the New York plan exclusions state:<\/p>\n\n
\nMedicare is primary in these scenarios:<\/p>\n\n
\nmember is in.<\/li>\n