Can Medicare be secondary insurance?

Medicare can simultaneously coexist with other types of insurance. For example, people who are turning 65 and newly eligible for Medicare may still be working and already have employer coverage. Medicare can serve as the primary or secondary payer in these situations. Read on to learn more below.

Primary vs. Secondary Payer

In order to understand how two insurance plans can coexist, you need to understand primary and secondary payers. When you have two plans, you have two payers. There are a variety of situations in which one plan may pay first and the other will pay the remainder. The plan that pays first is called the primary payer. The other plan is then called the secondary player. Normally, the primary payer pays up to the limits of its coverage. The secondary payer pays if there are costs that the primary payer does not cover. However, the secondary payer isn’t necessarily obligated to pay all of the uncovered costs.

How Medicare Can Be the Primary vs. Secondary Payer

When you have your employer coverage, there are situations in which Medicare will be the primary payer or secondary payer. Generally, Medicare will pay first if:

  • You have retiree insurance
  • You are 65 or older and have a group health plan based on current employment with an employer than has fewer than 20 employees
  • You are under 65, have a disability, and have group health plan coverage based on current employment with an employer that has fewer than 100 employees
  • You have Medicaid.

Your employer insurance will pay first if:

  • You are 65 or older and have a group health plan based on current employment with an employer than has 20 or more employees
  • You are under 65, have a disability, and have group health plan coverage based on current employment with an employer that 100 or more employees
  • Have End-Stage Renal Disease (ESRD)

If you have ESRD, your group health plan will pay first for the first 30 months and then Medicare will pay first.

Getting the Most Out of Two Insurances

There are certain times when having two insurances can save you money or it can cost you money. You should talk to your union or employer representative to understand your employer coverage. You should also talk to a qualified agent about Medicare coverage to understand which parts of Medicare you need based on your employer’s coverage. Contact Temmen Insurance to start understanding your options today.

Recent Posts