Can you enroll in Medicare part B only?
June 9, 2010 5:15 PM   Subscribe

Can you enroll in Medicare Part B (medical) only?

My mom receives SSDI and has been eligible for Medicare for years; however, she has had continuous coverage under my father's employer group plan (currently Blue Cross Federal Employees Basic) so she did not have to enroll in Medicare. Their benefits keep getting cut every year, and now my mother is interested in Medicare.

According to Blue Cross, if an employee or spouse has Medicare part B only, then Medicare would be the primary payer on those services covered by part B, and Blue Cross would pick up anything after. That would save my parents a LOT of money. But if they have parts A and B, then Blue Cross is the primary, which is the same as the current situation.

Blue Cross would still pay what they do for hospital and prescriptions, so she wouldn't need any other parts of Medicare. So, is it possible to enroll in part B without enrolling in part A?
posted by Danila to Health & Fitness (8 answers total)
You can call 1-800-MEDICARE and they can give you a for-sure answer on this pretty quickly.
posted by fructose at 5:27 PM on June 9, 2010

Best answer: Only answer I could find (without going through the Medicare pre-qualification on their site) is from MSN Health:

Who's eligible for Medicare Part B coverage?

Your parents are eligible if they're U.S. citizens or legal residents who have been in the country for five consecutive years. They don't need to have Medicare Part A in order to enroll in Part B.

posted by fireoyster at 5:29 PM on June 9, 2010

Response by poster: Thanks for the answer. Although for future reference, it doesn't apply anyway because I found this:

When You or a Covered Family Member have [Blue Cross] and Are eligible for Medicare based on disability: The Primary Payer is: Medicare, if you are an annuitant. [Blue Cross], if you are an active employee

When your Service Benefit Plan coverage
pays your health care expenses first, your
benefits are the same as those of any other
federal employee who is working, and your
Medicare and Service Benefit Plan de­ductibles,
copayments and coinsurances are not waived.

posted by Danila at 5:46 PM on June 9, 2010

I think you're misunderstanding the way that coordination of benefits work: if your mother has Medicare secondary to Blue Cross, it would not be the same as her current situation. It means that after Blue Cross pays the primary claim, any residual balance that would bill to your mother if she only had Blue Cross would instead bill to Medicare, they pay the secondary claim according to their own reimbursement logic, and then, only after Blue Cross and Medicare have both adjudicated the claim, would any residual balances drop to your mother. It would probably result in lower bills to her than her current situation, though I can't tell you whether it would be better or worse than having Blue Cross secondary to Part B.
posted by strangely stunted trees at 5:50 PM on June 9, 2010

Response by poster: It is the Blue Cross "de­ductibles, copayments and coinsurances" that are killing my parents' finances, and as long as Blue Cross is primary then my understanding is she still has to pay those. If Medicare were primary, then the copayments and coinsurances would be waived, according to the materials Blue Cross sent me. Not having to pay all the doctor copays and medical equipment coinsurances would mean a substantial savings, even with the Medicare premium. But that's only if Medicare is primary.
posted by Danila at 5:58 PM on June 9, 2010

Danila, since you're local why don't you contact me privately and I will give you a referral to a benefits attorney at Community Legal Services who will give your mother correct advice on Medicare issues free of cost.
posted by The Straightener at 6:08 PM on June 9, 2010

It is the Blue Cross "de­ductibles, copayments and coinsurances" that are killing my parents' finances, and as long as Blue Cross is primary then my understanding is she still has to pay those.

Yes, Blue Cross still won't pay your mothers deductibles, copayments and coinsurances if they're the primary. A bill for them will still be generated.

But the bill will go to Medicare, not your mother. Medicare will then pay that bill according to its own rules, and only at that point will a bill for what neither Medicare or Blue Cross will pay out nor have adjusted by their contracted discounts go out to your mother. That said, Medicare of course has copayments of its own, doesn't cover everything, and sometimes its medical necessity restrictions are stricter than that of a private insurer, so she'll certainly be getting a bill for something, but it will be a lower bill than from Blue Cross alone.

I'd certainly advise, though, that you take The Straightener up on his offer of a referral, since this is a highly complicated area, and it's a very good idea to consult with a professional who can familiarize themself with the detail's of your mother's situation and estimate out what the actual financial impact of this would be, and in particular whether the savings would be greater than the additional Medicare premiums.
posted by strangely stunted trees at 6:15 PM on June 9, 2010

Yeah, I got exactly the guy Danila needs to talk to, he's a legal aid attorney in Philly who does nothing but Medicaid/Medicare and just gave me a training on public benefits last week.
posted by The Straightener at 6:21 PM on June 9, 2010

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