Medicare can be a great thing for those of us who can’t afford private insurance, but the complexity of the system makes it difficult to understand how bills are paid. Patients should know that there are two basic types of insurance a person can have. The first is primary insurance, it is the form that will pay the most of health bill. Next is supplemental insurance that will usually pickup some, if not all of the amount that the primary insurance doesn’t. That should help answer the question of who pays first, Medicare or Medicare Supplemental?
If you have a privately bought insurance policy that covers a majority of the medical expenses, then you probably have Medicare Supplemental. If Medicare is your primary insurance then you might use private insurance as a supplement. Generally it will be up to the primary provider to cover their portion first, then the supplemental will determine how much they must cover out of the remainder. Medicare or Medicare supplemental can be beneficial but it is primary Medicare that will expected to pay first if at all.
Beyond primary and supplemental insurance it is important to remember that each individual policy has different rules and regulations that dictate how payment is made. Some policies may actual not allow for payment on certain procedures, even if they are primary. Sometimes, the supplemental policy will cover that money and takes the primary spot in paying for the service. In general, between Medicare or Medicare Supplemental it is the first that pays first. That isn’t always the case however, and individual policy regulations will dictate the proper procedure for billing purposes.