How Do Medicare And Health Insurance Work Together?

Facts About Medicare And Health Insurance

Understanding how Medicare works with health insurance plans can be confusing. Medicare and health insurance work together in many different ways. Medicare may pay first depending on the type of supplementary health insurance. Paying first means paying medical bills up to the predetermined limit of a coverage plan, not who pays first in time. Medicare could be a first, second, or even third payer.

Medicare And Health Insurance From Employers

Medicare works with employer insurance in a few different ways. Most people with employer insurance enroll in Medicare Part A because it requires no premium. Medicare Part B requires a premium. The part(s) of Medicare you need will depend on your employer. If your employer has fewer than twenty employees then you will need both Parts A and B for adequate coverage. If your employer has more than twenty employees then your employer would be the first payer. This means that you should enroll in Part A (at no cost to you). For specifics of your employer coverage and how it works with Medicare contact the proper administrator at your job.

Medicare And Group Coverage Plans

Group coverage plans are offered from your employer or union or your spouse’s employer or union. While working, group coverage plans work with Medicare as mentioned above. When you retire group coverage plans work differently. Some coverage plans will end or have changes to their benefits or premiums. Not enrolling in Medicare when you are eligible is one reason why group coverage may end. Group coverage plans for the disabled are generally the second payer. These plans are the first payer for people with End Stage Renal Disease regardless of whether they have Medicare.

Medicare And Other Health Insurance Plans

Medicare would be the first payer when combined with Medicaid or TRICARE. Medicare is the second payer for no fault/liability coverage and worker’s compensation. Medicare may pay first with COBRA depending on how you qualify for Medicare (e.g. kidney disease). For more basic information on Medicare you can call 1-800-Medicare (1-800-633-4227).

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