1. 11498 POINTS
    Jason Goldenzweig
    Co-Founder, TermInsuranceBrokers.com, Goldenzweig Financial Group, Las Vegas, Nevada
    If you only have Medicare A & B or Parts A & B plus a Medigap plan, Medicare is going to pay first.

    When you have more than one plan paying a claim, the process has to follow the coordination of benefits rules to determine who pays first and who pays second. The majority of the time, people who are on Medicare will have two types of coverage when they or their spouse works for an employer. Self-employed individuals will generally only be on Medicare and drop their under 65 policy (unless their spouse has group coverage they can be on).

    How big the company is and whether or not the insured employee is working will generally determine who pays first. If the employer has 20 or more employees, the employer plan will pay first and Medicare second. If the employer has less than 20 employees, Medicare will pay first and the employer will pay second.

    If you're on Medicare for a disability, the employer plan pays first and Medicare pays second if there are 100 or more employees - if there are less than 100 employees, Medicare pays first and the employer plan pays second.
    Answered on April 4, 2014
  2. 2310 POINTS
    Steve Adlman
    Owner, Alabama Medicare Plans, Birmingham, Alabama
    If you are 65 or older and work for a company that has more than 20 employees your employer plan is primary not Medicare. If you work for a company with fewer than 20 employees Medicare is primary not your employer coverage. If you are covered by an employer group retiree plan Medicare is primary and pays first and your retiree plan pays second.
    Answered on March 2, 2017
  3. Did you find these answers helpful?

Add Your Answer To This Question

You must be logged in to add your answer.

<< Previous Question
Questions Home
Next Question >>