Have Private Insurance and Are Turning 65? You Need Sign Up for Medicare Part B
If you are paying for your own insurance, you may think you do not need to sign up for Medicare when you turn 65. However, no...Read more
When signing up for Medicare, some people have other insurance, such as coverage from a current employer, or retiree’s or military insurance. Beneficiaries of Original Medicare or Medicare Advantage may keep their additional coverage, as the providers work together to bear health care costs.
People may have Medicare and other insurance simultaneously for several reasons.
People with more than one insurance provider may receive more coverage, as the providers allocate costs. Depending on the situation, Medicare might be the primary payer, or the other insurance provider may act as the principal insurer. Once the primary payer has covered the maximum amount, the secondary payer contributes to the remaining costs. Each insurance source will determine what and how much coverage it provides for services and treatments.
Though the coverage can be greater with multiple providers, you may be responsible for outstanding fees that neither program fully includes.
For those with two insurance providers, the “Medicare & You” handbook as well as the guide to “Who Pays First” (both in PDF format) explain the protocol that determines which provider is the primary payer.
In general, Medicare pays first when people have retiree health coverage or receive coverage from a smaller organization. An employer’s coverage typically takes precedence when it originates from current employment at a larger organization.
In other instances, Medicare is the secondary payer.
Those who qualify for Medicare as well as Medicaid can receive assistance from both programs. When people benefit from both programs, Medicare is the primary payer. If both Medicare and Medicaid cover the same service or treatment, Medicare pays first, and Medicaid contributes to any remaining costs.
Sometimes, Medicaid will pay for expenditures that Medicare does not cover. Medicare Part A bears hospital fees, Part B extends to outpatient medical costs, and Part D applies to prescription drugs. However, Medicare generally does not take care of nursing home expenses, which Medicaid can cover.
Speak to an elder law attorney to learn how having other insurance coverage affects Medicare.