Question: Is Medicare Primary Or Secondary Insurance?

Medicare is primary and your providers must submit claims to Medicare first.

Your retiree coverage through your employer will pay secondary.

Often your retiree coverage will provide prescription drug benefits, so you may not need to purchase Part D.

Can I use Medicare as a secondary insurance?

The one that pays second (secondary payer) only pays if there are costs the primary insurer didn’t cover. The secondary payer (which may be Medicare) may not pay all the uncovered costs. If your employer insurance is the secondary payer, you may need to enroll in Medicare Part B before your insurance will pay.

Is Medicaid primary or secondary insurance?

Private group insurance plans with more employees will have Medicare as secondary. Medicare is primary if the private plan is an individual policy. Medicaid and a health insurance plan – Medicaid is always the payer of last resort when there are multiple plans. TRICARE is your only health insurance coverage.

When Can Medicare be a secondary payer?

Situations when Medicare is a secondary payer include when: You are covered by a group health plan (GHP) through employment, self-employed, or a spouse’s employment, AND the employer has more than 20 employees.

How do you determine which insurance is primary and which is secondary?

The primary payer is the health insurance plan that covers the patient as an employee, subscriber or member. The secondary payer is the health insurance plan that covers the patient as a dependent.