Since 1-1-13, Medicare has been secondary, and in return for my Medicare annual premium outlay of between $1200 and $1300 (round numbers), I have been able to avoid paying a cent towards my employer's deductibles of between $1600 and $2000, and out of pocket max of between $3500 and $4000 - a very nice annual savings and return on my Medicare premiums (and also my employer's health insurance annual premiums of roughly $900 to $1800).
I suspect the good times are going to come to an abrupt end starting 1-1-15, when Medicare becomes primary and my employer's insurance secondary. If I understand the change in insurance precedence properly, the 20% portion that Medicare does not pay on each claim will drop into my employer's insurance $2000 deductible, and when that is met, will then be subject to my employer's insurance 15% copay, which will continue until I reach the full $4000 annual out of pocket max.
According to my calculations, even with the reduced reimbursement for each HHD treatment as paid by Medicare, the 20% portion as it drops into my annual deductible and then at a 15% copay, will have me paying out of pocket all through 2015 before I reach the $4000 out of pocket max.
In 2013 and 2014, the deductible and copay accumulation to out of pocket max was reached by late January of each year owed to the much larger amount reimbursed for each HHD treatment by my employer's insurance. The $3500 (2013) and subsequently $4000 (2014) out of pocket max amounts got picked up by Medicare and/or were never submitted by my provider's to Medicare, perhaps owed to the significantly lower reimbursement rates - roughly 1/3rd of my employer's insurance.
Unless my calculations are wrong, the new arrangement with Medicare primary and employer's insurance secondary, will produce little if any financial benefit for my Medicare premium investment - I will be stuck paying my employer's insurance $4000 out of pocket max in stark contrast to 2013 and 2014, when my out of pocket max was limited to my annual Medicare premiums of about $1200 to $1300, a difference of $2700 to $2800 per year out of pocket that I saved. Regrettably, this will remain the case until I decide to retire in 6 to 8 years and then become subject to a whole new set of medical insurance circumstances.