More Medicare Questions

Ugh. It is pretty cool that Medicare covers dialysis and transplant costs, but everything is so confusing. It is even worse if you have a secondary insurance from work or somewhere else. I endured several months of claim confusion and screwups during the time when Medicare switched to be my primary insurance.

Anyway, the rules state that I can keep Medicare for three years post-transplant. Since Medicare paid 80% of all my medical bills, except for prescriptions, while my work insurance paid the rest, I assume that arrangement will stay the same for the next three years. However, due to my prior salary, my monthly Medicare premiums for Part B is ~$500/month or ~$6000/year. Under coordination of benefit rules, I had to get Medicare since my work insurance will not pay for dialysis after 33 months. They did pay for the remaining 20% of medical bills and all prescriptions.

The premiums for my work insurance is $0; it is covered by the company. I do have a $3400 out-of-pocket maximum, which I hit in January each year due to dialysis. Post-transplant, Medicare continues to pay for 80% of my medical appointments, while my work insurance pays for the rest. Since they are secondary, the $3400 out of pocket max does not apply so I have not paid any medical bills this year, except for co-pays on medications.

So the question is whether I should continue to pay $6000/year for Medicare. If I cancel coverage, then my work insurance will cover everything, subject to the $3400 out-of-pocket max. Without dialysis, I have never come close that number so I will save a few thousand dollars a year. I cannot think of any downsides, other than if I lose my job. I also need to make sure there are no weird rules that says I have to have Medicare while eligible. I would make sense for my work insurance since they (or our company since we are self-insured) end up paying less if I keep Medicare. Also, if I quit or get fired, Medicare will keep covering 80% of my medical bills for three years; I am not sure how long COBRA lasts and it probably cost more than Medicare.

I posted this question on Reddit. Hopefully someone more knowledgeable has experienced the same issues and can help. I will probably call my work insurance too to see if they have any advice.