Diabetes and Medicare (for those under 65) (plan, cost, kidney, work)

[Mr. Rossi]

My wife, a long-time type 1 diabetic, is about to start dialysis due to kidney failure brought on by her diabetes. She is 50 years old. Medicare will cover dialysis and a kidney transplant even if you are under 65. She is currently covered under my employer insurance. I am having trouble figuring out if we'll be better off financially with the Medicare coverage, or whether we should stick my our employer insurance. Has anybody dealt with this issue? (I posted this in the Health Insurance forum as well.)

[legalsea]

I do not know, but perhaps this will help:

https://www.medicare.gov/Pubs/pdf/02179.pdf

It seems to indicate that you 'do both', with the employer's health insurance paying first, for 30 months, at which time Medicare will become the primary payer.

[Mr. Rossi]

That does help some, thanks. However, I still don't know if we'll be better off with Medicare. I have a high deductible plan at work. Once we hit 6k in out of pocket expenses we pay nothing (however, this is not entirely true for prescriptions). I'm concerned that by adding a monthly premium for medicare I'll end up paying more (especially this fiscal year since we are already at 5k in out of pocket costs).

[Flamingo13]

You should check w/your insurance - my late husband went on Medicare before 65 because of kidney failure. He retired on disability from his job and that insurance became primary for 3 yrs./Medicare secondary (that always the case in end stage renal failure) - then the insurances switch. It was good to have both because of the additional coverage.

[Jimrob1]

I have Medicare and I was able to continue, my BC/BS thru my employer into retirement. I'm also a Diabetic. I was sent to a Diabetic Education Class in Oct. The Diabetic Educator told me Medicare pays for this and I was allowed 10 hours of class. So I went even though I have been a Diabetic for decades. Well today I got the statement of benefits paid from Medicare. They denied the claim for the class as did the BC/BS. The bill is almost $300. So I don't know what is going on, it should have been paid by one or the other. I am going to the health provider and tell them to write it off, since they told me this was a paid class thru Medicare.


I don't trust Medicare or Health Insurance. I'm finding the baloney I was told that with both coverages combine, that I would have just about no health care costs. I don't believe them as Medicare has denied payments for doctors visits before this latest problem. They are fickle not efficient and just plain untrustworthy. I may even drop Medicare if I find out this foolishness is going to continue. I will then just keep my BC/BS, as I had before Medicare.


I don't know if everyone falls under this, but I know I do. Every year after 65 that one does not subscribe to Medicare. Then there is a 10% penalty for every one of those years, should the person take it later on.