You are here: Home Government ... Medicare 101: An ... Coordination of ... Overview
Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.

Coordination of Medicare And Other Health Benefits


Next »


If you have Medicare and one or more other health care coverages and have a claim, Medicare and industry wide rules determine how costs are split between them. The rules answer such questions as:

  • What if one health coverage includes the subject of the claim, but the other doesn't?
  • Which health insurance pays first and which pays second?

Medicare speaks of this process as Medicare and "Other Health Benefits." The private sector calls it "Coordination of Benefits." To make the discussion in this article fit with the way people speak, we will call the process "Coordination of Benefits."

Coordination of benefits are intended to assure:

  • That your medical bills are paid without conflict or delay.
  • That the doctor or other health care provider only receives one payment.
  • That you don't make a profit by seeking medical care.

The rules to determine which plan is primary and which plan is secondary depend on the type of coverage you have in addition to Medicare. The alternatives are:

If you have more than one health insurance coverage, and Medicare is not one of them, the rules are different. If this applies to you, click here.

NOTE: Bills to Medicare when there is more than one coverage are now sent to a national claims crossover contractor,  the Coordination of Benefits Contractor. This is instead of individual Medicare contractors.

If you still have questions after reading this article, call the Medicare number which answers coordination of benefit questions: 800.999.1118

Please share how this information is useful to you. 0 Comments


Post a Comment Have something to add to this topic? Contact Us.

Characters remaining:

  • Allowed markup: <a> <i> <b> <em> <u> <s> <strong> <code> <pre> <p>
    All other tags will be stripped.