Jeff Branscome writes about Spotsylvania County.
Supervisor Jerry Logan explains county health insurance policy and Medicare
I received numerous e-mails and blog/story comments about the county Board of Supervisors expense reports and the health insurance the country provides to three supervisors. Folks asked about why these supervisors are not using Medicare as their primary insurance, which would save local money.
Mr. Logan provided a response to those who questioned the policy or had questions anout Medicare. His response is as follows:
Spotsylvania County government has a long-standing policy wherein medical insurance benefits are offered to elected members of the Board of Supervisors, as County employees.
Medicare is health insurance for people 65 years or older. Please note the following basic language pulled directly from the federal Department of Health and Human Services Medicare site. The “group health plan” described below is equivalent to the Spotsylvania County group health insurance plan:
“Medicare has special rules that apply to beneficiaries who have group health plan coverage through their own or their spouse’s current employment. Group health plans of employers with 20 or more employees must offer these people the same health insurance benefits under the same conditions that younger workers and spouses receive.”
“If you or your spouse stops working and you are already enrolled in Part B:
Notify your Medicare carrier by phone or in writing that you or your spouse’s employment situation has changed.
Give the carrier the name and address of the employer plan, your policy number with the plan, the date the coverage stopped and why.
When receiving health care services, tell the provider that Medicare is now your primary payer and should be billed first. Give the date your group health coverage stopped. “
Please note as indicated above by the section with bolding (added) that, according to Medicare, as long as an individual or his/her spouse is working and the individual is covered by the employer’s insurance, that insurance is considered “primary” and Medicare is considered to be a “secondary” plan. This is non-negotiable, as established by the federal government.
While there may be benefit in “reversing” the primary and secondary status designations to help alleviate costs to the County, it is unfortunate that the reversal cannot be done and that Medicare cannot be a primary payer. I hope this helps clarify the county’s current policy on Medicare. I understand that Stafford has a plan in place for "reversal", but we presently do not have enough full time retirees to qualify. If we join policies with the School Division, that could change.