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Who is primary if person has medicare and not 65 years but also has group coverage?
Wiki User
∙ 15y ago
How many people work at the group? Why does someone under 65 have medicare if they are able to work? Why does it matter which company is primary, just turn in the claims. http://www.medicare.gov/Publications/Pubs/pdf/02179.pdf Medicare's 43 page booklet on who pays first
Wiki User
∙ 15y ago
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When was the first group coverage emerged in?
medicare
Who is the primary payer when member has employee group and medicare?
Generally, Medicare is primary.
When is medicare disability prime over a group health plan?
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.
When a Medicare beneficiary has employer supplemental coverage Medicare refers to these plan as?
large group health plan
Can you carry primary insurance after you retire and go on medicare?
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.
If a small group is in a PEO is medicare primary or secondary?
Medicare is always the primary insurance unless someone is still working
Can medicare be used for secondary insurance if the primary insurance is paid by your employer?
Medicare is primary if your group is under 20 lives. 20 lives or more and medicare is secondary to your employer paid group plan.
Who pays first if you have medicare and are retired hourly from General Motors?
Chances are Medicare would pay first as long as you are no longer working, or if your spouse does not have you covered under insurance through their employer. If your spouse IS working and you do have coverage through them, the group insurance would be primary if their employer has more then 100 employees working for them. Otherwise, Medicare will be primary.
When does Medicare become the primary insurance?
Medicare is only secondary to your group coverage if you work for a company with 20 or more employees (could be a combination of part-time and full-time, based on total number of hours per year) and you worked 20 weeks or more, in the current or preceding year. They do not have to be consecutive weeks. If you work less than 20 weeks or your employer employs less than 20 employees, or both, your medicare coverage is your primary insurance coverage. Primary status of group benefits takes place as soon as the employment and work week criteria are met. It will be primary for at least the rest of the current calendar year and all of the following year. Primary status for medicare takes place on January 1st of the following year after an employer employs less than 20 employees or you work less than 20 weeks in that year. Medicare remains primary until employment or work week criteria meet levels to make group benefits primary.
If you have medicare and your spouse also has you as a dependent on their insurance which is primary and which is secondary?
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
My son receives Social Security disability and Medicare. I also carry him as a dependent on my group health insurance through work. Which insurance (group health from my employer or Medicare) is his primary insurance?
Your job insurance is the primary. Usually medicare/disability comes first then others supplement.
I understand when Medicare is primary and when Medicare is secondary. What is the difference in coverage between a Medicare Supplement and Medicare as a secondary insurer?
If you have a Medicare Supplement then the provider will bill Original Medicare first. At that time Medicare will pay the allowable amount and then return an explanation of benefits stating the beneficiary's portion. Based on the Medicare Supplement Plan that is in place (A-N) the Medicare Supplement will pay a portion or all of the remaining amount due. If they pay only a portion based on the plan (A-N), then according the plan guidelines, the beneficiary would pay any outstanding amount at that time. If a Medicare beneficiary is covered on a employer or retiree group plan and due to the size of the plan, the group plan is primary, then the group plan benefits will apply first and any amounts due by the Beneficiary will be billed to Medicare second. If it is a Medicare covered service, then Medicare will pay the remaining amount due as the secondary payor up to the amount allowed by Medicare. If the service is not allowed by Medicare, than the beneficiary's co-insurance or co-payment under the group plan would be their responsibility.
