What Is A Medicare Overlap?



When a person retires, he may receive a health care benefit from his employer as part of his pension package. The benefit package helps. When a person reaches the age of 65, he also qualifies for Medicare plans. If he continues working or receives a health care plan as part of a pension in addition to Medicare, an overlap may result.

What is a Medicare Overlap?

A Medicare Overlap occurs when a private health insurance plan provides some of the same coverage that Medicare does. Unless a patient tells his doctor’s office otherwise, Medicare will be billed first, if the doctor accepts the government sponsored health insurance plan. If the doctor’s office does not accept Medicare, only the primary payer will get billed for services.

A Medicare overlap is usually not a big deal. It provides additional coverage and can reduce how much a person pays out of his own pocket for health insurance costs. A Medicare recipient must inform the governing body of a Medicare Overlap before he enrolls in any of the Parts covered by the government.

Does a Medicare Overlap Cause Any Problems?

As long as Medicare knows that the overlap exists, a patient should not experience any problems of gaps in his health coverage. If a retiree forgets to inform the agency that governs the program of this possibility, it may take a while for the insurance program to pay the doctor billing them for services that he rendered.

Most people know whether or not there is a potential for a conflict between private health insurance and items covered by Medicare. If a person is preparing for retirement or old enough to receive Medicare, he should request the necessary forms to make sure both insurance programs run smoothly when he enrolls in the government-sponsored program.



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