Best way to switch from medicare to hospital based hmo

Question

I was so relieved to find this forum and hope you can help with my dilemma. I work in radiology and have been hiv+ for 21 years. 2 weeks ago I went from per diem status to full time status at my hospital job. I currently have ADDP and Medicare A/B. I have to pay the full Medicare premiums. I would like to keep Medicare even with premiums close to $400 per month. I have to sign up for employee health insurance soon. Problem is my hospital makes it very expensive to select an out of network health plan. If I select the hospital based health plan I would need to use my workplace for pharmacy, emergency room, surgical, diagnostic testing and in network doctors. The hospital based health plan is basically free or ridiculously low cost. I feel I should select an out of network medical plan for privacy. But if I select the out of network health plan, most medical treatment is only covered at 50% or less which would put a severe financial strain on me. My coworkers would have access to my health information if I were to have healthcare needs at my job such as surgery, emergency medical treatment or a hospital stay. I don't trust that my health information would be kept confidential. If my health information is leaked I would have no proof of who leaked it especially if it was medically necessary for my coworkers to access my health information to provide treatment. My hospital says it is committed to hiring older workers like me and people covered under ADA. They even have a questionnaire asking if I could qualify for ADA. It even goes so far to ask what the disability is. I don't know if I should fill out the questionnaire. Would it be beneficial to immediately protect my job under ADA? I don't know if medicare would pay the leftover costs if I select an out of network medical plan. I am sick with worry. The last full time hospital job I had started writing me up for minor mistakes after 9 years of stellar reviews. It seemed suspicious the actions started after I had to disclose to Occupation Health I was HIV+ . I can't prove I was fired as a result of this disclosure. I am terrified it could happen again. Any advice on how to protect myself would be appreciated.

Answer

My first question would be are you positive that you can't simply decline your employer's health insurance? Most employers permit that, even encourage it as it lowers their cost. They can't force people to take insurance if it against their religion, and that same exception should be available to anyone else who doesn't want or need the coverage.

If you can't refuse coverage then you need to read Medicare's book on "Who Pays First?", A guide for persons with Medicare and Other Health Benefits. CMS02179.
CMS02179. It will show you how the two plans work together and which plan would pay before the other. It will confirm that Medicare would still pay if you use providers that are outside your hospital plan's network, as long as those providers accept Medicare.

The best way to protect your medical privacy is to not use hospital facilities, and to never mention your medical condition to anyone, including "friends" at work.

Generally, the only time I recommend asking for protection under ADA (Americans with Disabilities Act) would be if you find yourself having a problem performing one or more of your job duties and need to ask for Reasonable Accommodation under the ADA law.Otherwise, they don't need to know.