WHAT IS THE DIFFERENCE BETWEEN PRIMARY AND SECONDARY COVERAGE?
When you have Medicare and another type of insurance, Medicare
will either pay primary or secondary for your medical costs. Primary
insurance pays first for your medical bills. Secondary insurance pays
after your primary insurance. Usually, secondary insurance pays some or
all of the costs left after your primary insurance has paid (for example,
deductibles and copays).
WHO PAYS PRIMARY AND WHO PAYS SECONDARY?
HOW DOES MEDICARE WORK WITH JOB-BASED INSURANCE?
Job-based Insurance is coverage you have from your, your spouse’s or
sometimes your family member’s current work.
If you are eligible for Medicare because you are 56 or older:
– Job-based insurance is primary if it is from an employer with
20+ employees. Medicare is secondary.
– Job-based insurance is secondary if it is from an employer with
fewer than 20 employees. Medicare is primary.
If you are eligible for Medicare because you’ve collected Social Security Disability Insurance (SSDI) for 24 months:
– Job-based insurance is primary if it is from an employer with
100+ employees. Medicare is secondary.
– Job-based insurance is secondary if it is from an employer with
fewer than 100 employees. Medicare is primary.
If your job-based insurance will be primary, you may decide to delay
Medicare enrollment because you already have primary coverage and
do not want to pay the additional monthly Part B premium. If your job-
based insurance will be secondary, you should enroll in Medicare Part
B when you’re eligible to avoid high costs for your care. If Medicare is
supposed to be your primary coverage, your job-based coverage may
provide little or no coverage if you are not enrolled in Medicare Part B.
HOW DOES MEDICARE WORK WITH RETIREE INSURANCE AND COBRA COVERAGE?
Retiree insurance is a form of health coverage an employer may provide to former employees. Retiree coverage is almost always secondary to
Medicare. This means you need to enroll in Medicare to be fully covered.
COBRA is a federal law that extends the option to purchase coverage to employees and their spouses/dependents once the employee leaves their job or otherwise loses coverage. If you have COBRA when
you become Medicareeligible, COBRA coverage usually ends the date
you get Medicare. You should enroll in Part B right away. If you have
Medicare Part A or Part B when you become eligible for COBRA you
must still be allowed to enroll in COBRA. Medicare is primary insurance,
and COBRA is secondary insurance.
March 2020 Medicare Update
MEDICARE + EMPLOYER-BASED COVERAGE
WHAT IS THE DIFFERENCE BETWEEN PRIMARY AND
SECONDARY COVERAGE?
When you have Medicare and another type of insurance, Medicare
will either pay primary or secondary for your medical costs. Primary
insurance pays first for your medical bills. Secondary insurance pays
after your primary insurance. Usually, secondary insurance pays some or
all of the costs left after your primary insurance has paid (for example,
deductibles and copays).
WHO PAYS PRIMARY AND WHO PAYS SECONDARY?
HOW DOES MEDICARE WORK WITH JOB-BASED INSURANCE?
Job-based Insurance is coverage you have from your, your spouse’s or
sometimes your family member’s current work.
If you are eligible for Medicare because you are 56 or older:
– Job-based insurance is primary if it is from an employer with
20+ employees. Medicare is secondary.
– Job-based insurance is secondary if it is from an employer with
fewer than 20 employees. Medicare is primary.
If you are eligible for Medicare because you’ve collected Social Security
Disability Insurance (SSDI) for 24 months:
– Job-based insurance is primary if it is from an employer with
100+ employees. Medicare is secondary.
– Job-based insurance is secondary if it is from an employer with
fewer than 100 employees. Medicare is primary.
If your job-based insurance will be primary, you may decide to delay
Medicare enrollment because you already have primary coverage and
do not want to pay the additional monthly Part B premium. If your job-
based insurance will be secondary, you should enroll in Medicare Part
B when you’re eligible to avoid high costs for your care. If Medicare is
supposed to be your primary coverage, your job-based coverage may
provide little or no coverage if you are not enrolled in Medicare Part B.
HOW DOES MEDICARE WORK WITH RETIREE INSURANCE
AND COBRA COVERAGE?
Retiree insurance is a form of health coverage an employer may provide
to former employees. Retiree coverage is almost always secondary to
Medicare. This means you need to enroll in Medicare to be fully covered.
COBRA is a federal law that extends the option to purchase coverage
to employees and their spouses/dependents once the employee
leaves their job or otherwise loses coverage. If you have COBRA when
you become Medicareeligible, COBRA coverage usually ends the date
you get Medicare. You should enroll in Part B right away. If you have
Medicare Part A or Part B when you become eligible for COBRA you
must still be allowed to enroll in COBRA. Medicare is primary insurance,
and COBRA is secondary insurance.
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