Q: I recently applied for my Medicare benefits and soon after received a form to complete asking for information about employer’s health plans that I might be entitled to. Why would Medicare need such information?

A: Medicare needs to know about other health care coverage to establish your benefits file and to determine whether or not Medicare will be your primary coverage.

Usually when a person becomes eligible for Medicare, Medicare serves as the primary health care payer. However, some people are entitled to other health care insurance which pre-empts Medicare as the primary health care provider shifting Medicare’s role to that of secondary payer.

The questionnaire you received asks if you have health care coverage under an employer’s health plan either through your or your spouse’s current employment. This initial enrollment questionnaire provides information for the establishment of your Medicare benefit file. Medicare needs to determine if they will be the primary or secondary payer for your health care costs. Without this information Medicare would not be able to pay your claims in a timely manner and you could be billed by your providers for services rendered.

If your or your spouse’s employer coverage is through an HMO you must also provide this information to that HMO. They will then coordinate payments between Medicare and the employer plan.

If you are 65 years old or older and continue to work or you are 65 or older and have a spouse, of any age, who works Federal law protects you from discrimination in employer health care coverage. An employer of 20 or more employees who offers health care benefits must offer you and your spouse the same health care benefits under the same conditions as those offered to other employees.

You have the choice of accepting or rejecting the plan offered by your or your spouse’s employer. If you accept the plan it will be your primary health care coverage as long as you or your spouse continue that employment. Medicare, if you decide to enroll, would then become your secondary insurance and could assist with payment of Medicare covered services that are not covered under the employer plan.

If you decide to reject the employer’s plan then Medicare will be your primary plan.

It is very important that you let your health care providers know what plan is providing your primary coverage. If it is an employer’s plan providers of care will need the name and address of the employer’s plan and policy number. Providers should be instructed to bill that plan first for any services received.

As soon as you are no longer covered by an employer’s plan it is very important that you enroll in Medicare Part B (Medical Coverage), if you have not previously done so. You should also notify the insurance carrier or HMO responsible for your Medicare claims that you are no longer covered by an employer’s plan and that Medicare will now be the primary payer. Make sure they know the effective date of this change.

Last, but not least, inform your health care providers of your change in primary coverage so they can direct their claims to the proper insurer for payment.

Q: In a past column you wrote about the OSHER Lifelong Learning Institute academic semester courses. I am looking for single lectures. Does Osher offer such individual lectures?

A: During semester break OLLI will be offering several single session lectures. These lectures will start on June 1 and will be offered at Ventura Adult and Continuing Education, Channel Islands satellite campus in Thousand Oaks and an expanded site at CSU Channel Islands main campus.

Fourteen different courses are being offered and they will cover a variety of topics. For those interested in history there will be Ivor Davis’ “Eyewitness to History; From the Beatles to Bobby Kennedy.” If interested in science there will be Fan’s “The Science of Acupuncture” and if culture is your interest there will be Garlington’s “Gandhi: A Life.”

Enrollment is currently in progress and can be completed by calling 437-2748.

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