If you have multiple forms of insurance, it’s important to coordinate your benefits to make sure that claims are paid correctly. You may need to coordinate coverage if you have Medicare and are also enrolled in a union- or employer-sponsored group health plan, Medicare supplemental insurance, or Medicaid.
If you have a group health plan (GHP) and your employer has 20 or more employees—or has less than 20 employees but is enrolled in a Multiple Employer Welfare Arrangement (MEWA)—Medicare will pay secondary to the GHP.
If you have a group health plan (GHP) and your employer has less than 20 employees and is not enrolled in a MEWA, then the insurance company can choose to pay as primary or secondary. If the GHP pays primary, Medicare will pay secondary, but if the GHP pays secondary, you may pay have a reduced premium since Medicare will pay primary. Contact your plan administrator for more information.
Medicare Supplement Plans and Medicaid will pay secondary to Medicare. You may be enrolled in a Special Needs Plan (SNP), a type of Medicare Advantage Plan that coordinates your Medicare and Medicaid benefits. A Medicare Supplement is a separate policy purchased through a private insurance carrier. If you are eligible for Medicaid, you likely do not need to enroll in a Supplement.
Do you need to let Medicare know that you have other coverage? Generally, the insurance companies are required to notify Medicare if they are responsible for paying claims.
When you visit a healthcare provider, make sure to let them know that you have multiple coverages, and in which order to bill them. This can help prevent delayed payment of claims from incorrect order of submission and may help you avoid receiving bills that you do not need to pay.
By: Steven Thomas Smith
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