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Coordination of Medicare And Other Health Benefits

Medicare and Group Health Insurance: People Who Are Disabled (Not Due To End Stage Renal Disease or ALS) AND Under Age 65

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If you have Medicare because you are disabled and under age 65, Medicare is Secondary if:

  • You are covered under an employer's plan because of your current employment or the current employment of a family member, whether it is a spouse, parent, or significant other AND
  • The employer has 100 or more employees.

Otherwise, Medicare is Primary.

Examples:

  • Your health insurance is continued by your employer because you are collecting Long Term Disability benefits (not due to your current employment).  Medicare is Secondary. Your former employer's health insurance is Primary.
  • You are covered as a dependent under your spouse's or significant other's policy from the employer where s/he currently works. Your spouse's employer has 500 employees. Your spouse's plan is Primary.  Medicare is Secondary.
  • You are 21 and covered as a dependent under your Dad's employer plan. His employer has 55 employees. Medicare is Primary. Your Dad's coverage is secondary.

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