Choosing the Right Coverage for You
Step by step
The first step is to collect information on what types of insurance you qualify for and determine the monthly premium for each option. For employer-sponsored insurance, there may be multiple plans from which you can choose.
The second step is to know what your medical costs are and what medical you need covered by insurance.
The third step is to evaluate how much of your medical costs are covered by each insurance option. For each insurance option, how much will you need to pay before insurance kicks in (deductible), how much will they cover, and how much will your copay be.
The last step is to compare how much each monthly plan costs, the out-of-pocket costs for each insurance option. Evaluate which insurance option will cover the most based on your needs for the least amount of money out of pocket.
Stacking Health Insurance
Small vs. large business effects primary – Medicare pays first if an employer has 100 or fewer employees
Medicare’s Your Guide to Who Pays First
Navigating the different healthcare coverage options can get complex if you have a disability. As we discussed above, there are three types of help insurance: employers sponsored plans, Medicare, and Medicaid. When you have multiple insurance plans, most of the time they will coordinate together to ensure that costs are covered in the correct way. Make sure to provide all of your healthcare providers with all of your insurance cards in order to ensure that they are properly billed.
If you have multiple insurance plans, typically medical bills are paid in the following order:
- Primary: Employer-sponsored plans
- Secondary: Medicare
- Tertiary: Medicaid
Please note that if you have Medicare and an employer-sponsored plan with an employer that has 100 employees or less, Medicare will pay first. Typically, it is not worth paying for employer-sponsored health insurance in this scenario.
Medicaid always pays last. If you have Medicaid, it will cover your copays in most cases. Medicaid will also pay most of your health costs until you meet your deductible. Through Medicaid’s Premium Payment Program, your premium for your employer-sponsored plan may also be covered.