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Answered 2008-09-15 17:08:43

Yes -- It is ALWAYS best to call to coordinate your benefits

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As long as the only reason you are covered by Medicare is because of a disability and you haven't reached the minimum age Medicare requires to become eligible naturally, then the number of members in the group health plan will determine who is primary or secondary. Group plans with fewer than 100 members are considered to be "small" businesses and Medicare would be primary. Conversely, "large" businesses (more than 100 members) will be primary over Medicare. It doesn't matter whether the group plan is provided by you or your spouse. At the time you reach Medicare's required age to naturally become eligible with them, your case will be reviewed. At that point, the group size doesn't matter. If you have other coverage provided by you or your spouse, it will always be primary over Medicare. Medicare won't become primary until both you and your spouse have retired and are no longer covered by a group health plan. Medicare supplement plans are always secondary to Medicare, but then those aren't group health plans.


Question isn't clear, but ordinarily Medicare is the primary payor and your retiree coverage is secondary.


Medicare Part A which is "Hospital Insurance." It pays as primary insurance for the long-term disability. It helps pay for inpatient hospital care, inpatient care in a skilled nurshing facility, home health care and hospice


if you have medicare,retired but spouse works.spouse ins is primary and medicare secondary. if you are a child both parents has anthem,birthday rule has to apply. the parent who is born first is primary and the parent who is born later is secondary does not matter if parents are married or not


Medicare is primary unless you are working and have coverage thru your employer. Coverage thru the spouse's employer would be secondary to your own Medicare coverage.NO. The answer posted above is incorrect! Medicare is Secondary.Medicare is secondary when :-The individual or his/her spouse is currently employed/working and covered under an employer group health plan as a result of current employmentsee this linkhttp://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=871


The answer to this question depends on what kind of secondary insurance you have - is it a group health plan? Is it a supplement? If Medicare is primary, there are still deductibles, copays, coinsurance that would need to be satisfied by your secondary insurance. Based on your question, I'm assuming that you have a group health plan with a copayment as your secondary insurance. If so, then yes, you would pay your copayment but it would not exceed the part B deductible.


Where I work, the employer plan would be secondary and medicare would be primary. It might depend on how the company has it set up but I can't imagine any company today wanting to be the primary insurer.


In most cases, Medicare is primary. Some of the most common situations where Medicare can pay secondary are: -The individual or his/her spouse is currently employed/working and covered under an employer group health plan as a result of current employment. The company has 20 or more employees or participates in a multiple-employer or multi-employer group health plan where at least one employer has 20 or more employees. -Individual in question is entitled to Medicare as a result of a disability, the company has 100 or more employees, or participates in a multi-employer/multiple-employer group health plan where one employer has 100 or more employees. -The individual in question is Medicare entitled due to end-stage renal disease. Medicare is the secondary payer to a group health plan until a 30-month coordination period has ended.



Contact your SHIP (State Health Insurance Program) -- the local Area Agency on Aging would have the phone number or be able to help you with one of their Medicare counselors.


In searching for an answer to the this question,google'd for "Medicare Secondary Payer provision;"this website question was one of the top. hit'safter researching found the following: I called Medicare and asked them.Medicare told me that since my spouse,who is not working, is eligible for medicare and is currently covered by my insurance that Medicare would be secondary. Also in looking thru documentation on the internet it looks to me as if what Medicare told me on the phone is correct that My Primary Insurance would still be primary Insurer and Medicare would be secondary. Extracted and underlined relevant information from links below is my understanding of Medicare as Secondary "Medicare benefits are secondary payer to large group health plans (LGHP) for individuals under age 65 entitled to Medicare on the basis of disability and whose LGHP coverage is based on the individual s current employment status or the current employment status of a family member. Under the law, a LGHP may not "take into account" that such an individual is eligible for, or receives, Medicare benefits based on disability" Also some companies are starting to charge employee extra for coverage of spouse if the employee's spouse can get insurance thru her employment or disability. Let's call it "Spouse Extra Charge".To the point of the "Spouse Extra Charge", my spouse is not employed and according to above in purple should be eligible for the "Spouse Extra Charge" waiver and not charged the "Spouse Extra Charge".google"employers charging extra for Health Insurance for Spouse"Some companies are charging from $10 to $110 extra a month to the premium for adding spouse if spouse can get insurance at their own employment.Links are below for medicare primary or secondary I found the following at ssa.govhttp://www.ssa.gov/disabilityresearch/wi/medicare.htmpart of link below at A and from theMedicare Secondary Payer (MSP) Manual http://www.cms.hhs.gov/manuals/downloads/msp105c01.pdfpart of link below at B A start of excerpt from http://www.ssa.gov/disabilityresearch/wi/medicare.htmCoordination of Medicare and Other Coverage for Working Beneficiaries with Disabilities Question: I am under age 65, disabled, working and have both Medicare and group health coverage. Who pays first? Answer: It depends. If your employer has less than 100 employees, Medicare is the primary payer if: * you are under age 65, and * have Medicare because of a disability. If the employer has 100 employees or more, the health plan is called a large group health plan. If you are covered by a large group health plan because of your current employment or the current employment of a family member, Medicare is the secondary payer (see example below). Sometimes employers with fewer than 100 employees join other employers in a multi-employer plan. If at least one employer in the multi-employer plan has 100 employees or more, then Medicare is the secondary payer for disabled Medicare beneficiaries enrolled in the plan, including those covered by small employers. Some large group health plans let others join the plan, such as a self-employed person, a business associate of an employer, or a family member of one of these people. A large group health plan cannot treat any of its plan members differently because they are disabled and have Medicare. A large group health plan must offer the same benefits to plan members and their spouses that are over 65 and disabled as are offered to employees and their spouses under 65. Example: Mary works full-time for GHI Company, which has 120 employees. She has large group health plan coverage for herself and her husband. Her husband has Medicare because of a disability. Therefore, Mary's group health plan coverage pays first for Mary's husband, and Medicare is his secondary payer. A end of excerpt from http://www.ssa.gov/disabilityresearch/wi/medicare.htm B start of excerpt from http://www.cms.hhs.gov/manuals/downloads/msp105c01.pdf 10.3 - Disabled Beneficiaries Covered Under a Large Group Health Plan (LGHP) (Rev. 1, 10-01-03) Medicare benefits are secondary payer to large group health plans (LGHP) for individuals under age 65 entitled to Medicare on the basis of disability and whose LGHP coverage is based on the individual s current employment status or the current employment status of a family member. Under the law, a LGHP may not "take into account" that such an individual is eligible for, or receives, Medicare benefits based on disability. ---------text excluded----- Medicare benefits are secondary to benefits payable under a LGHP for individuals under age 65 entitled to Medicare on the basis of disability who are covered under a LGHP as a result of the:Individual's current employment status with an employer that has 100 employees or more (see chapter 2, �30.3); orCurrent employment status of a family member with such employer.Special rules apply in the case of multiple employers and multi-employer plans. (See Chapter 2, �30.3.) Medicare is secondary for these Medicare beneficiaries even though the employer policy or plan contains a provision stating that its benefits are secondary to Medicare benefits or otherwise excludes or limits its payments to Medicare beneficiaries.Medicare is secondary payer to LGHP coverage based on an individual s or family members current employment status for services provided on or after August 10, 1993. B end of excerpt from http://www.cms.hhs.gov/manuals/downloads/msp105c01.pdf == ==


You do not determine which of your insurance policies are primary in cases where you have multiple health insurance policies. The Federal government passed a law several years ago making Medicare secondary to any other health insurance that you have through an employer or retirement program. This transferred billions of dollars per year from the Medicare and Medicaid programs to private insurance companies all at one time.


In general, yes. Medicare can be secondary insurance for a person otherwise entitled to it who continues to work beyond the age of 65 and participates in a health insurance plan offered by or sponsored by the employer. Additionally Medicare can be a secondary payer for disabled people who have their own coverage through their own employer's large group health plan (usually 100 or more employees), or large group health coverage that they have through a family member.


For Primary health care you dont get as much advantages however with secondary care you get better serivce and more advantages.


In general, 65; however, Medicare is also available to persons receiving disability Social Security benefits.


If you have insurance through your employer, and you are the policy holder,(the insurance is in your name) this insurance will be primary for you, and your spouses insurance policy will be secondary. The insurance policy thru your spouse's employer, (your spouse is the policy holder, or the insurance is in their name), this would be primary for your spouse, and your policy would be their secondary. Here's the phamplet from Medicare http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf


Secondary health care providers are medical specialists with specific expertise that your primary care provider will refer you to.


Yes. All you have to do is send in a cancellation letter or send it to your insurance agent and have them send to the HMO company. Once they receive it, they will then have medicare reinstated as your primary health care. Maybe get in contact with your agent and see about a medicare supplement policy. They will cover any gaps that medicare doesn't pay providing you can answer all their health questions yes.


Medicare does not require you to use it as your primary insurance; however, your private health insurance carrier probably will, especially if your employer is paying for your health insurance.


if primary paid more than allowed amount or if patient has primary insurance


Medicare is a government sponsored health insurance. This insurance is automatic for individuals over the age of 65, and for individuals who have been on disability for 24 months (from the approval date). Medicare does not pay for housing,.


No. You will have to use your health insurance first.


Aetna provides health insurance, dental insurance, pharmacy, medicare and disability insurance. It is an American managed health care company founded in 1853.


Aetna provides insurance that covers medical, dental, vision, Medicare supplement plans, disability, pharmacy, life, student health, and behavioral and mental health.



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