Individuals can have Medicare and employer-provided health insurance without supplements through coordination of benefits, which helps coverage providers determine payment responsibilities, reports Medicare.gov. Providers are designated primary payer, secondary payer and sometimes third payer.Continue Reading
Approximately three months before their 65th birthday, enrollees are sent a Medicare Initial Enrollment Questionnaire, which they can complete online or by phone, according to the Centers for Medicare and Medicaid Services. The questionnaire requests information about health coverage through employers or other sources. The coordination of benefits process determines primary payment responsibility and the roles of other contributors by compiling data from a number of sources including the Internal Revenue Service, the Social Security Administration, Pharmaceutical Benefits Managers and voluntary data sharing agreements with private employers.
Medicare is generally the first payer when retirees retain group health coverage from a past employer, states Medicare.gov. Many employers cancel health coverage when retirees become eligible for Medicare, but when they allow former employees to retain it, the retirees must enroll in Medicare Parts A and B to receive full benefits. Medicare sometimes makes conditional payments in situations where it is the secondary payer. When another insurance provider is slow in paying, Medicare pays the bill. The enrollee is responsible for ensuring the primary payer repays Medicare.Learn more about Insurance