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Medicare - Primary or Secondary?

hey everybody Randy Wolfe with quote by

Medicare org today's brief video is

going to touch on really a subject that

comes up for a lot of people who are

currently still working or that are on a

retiree type of plan we get asked this a

lot and it's basically you know who

covers first who's my primary and who's

my secondary and this can be kind of

confusing sometimes and so I thought

it'd be a great idea to shoot a real

quick video to just sort of go over that

answer some common questions that we

typically get so looking at it from a

standpoint of basically the the coverage

that comes in first whoever pays first

is considered primary and whoever comes

in and picks up the portion after that

is considered secondary so um a little

funny picture I thought about it I'll

think about shooting this video is you

know you know the old expression you

know which came first the chicken or the

egg

it'd be debated quite a bit but

oftentimes we get the question from from

our clients and people who call it and

have questions about um you know who

who's primary secondary so if you have

retiree insurance um

you if you're only if it's your you know

you're coming you look for if it's your

spouse's form employment in that

situation Medicare pays first if you're

65 or older and have a group health plan

based on either your spouse's current

employment or even your own turning

point employment and the employer has 20

or more employees in that scenario your

group health plan would pay first they

would be primary and Medicare would be

secondary

now same same deal 65 or older have

coverage through your employer or your

spouse's employer and that company has

fewer than 20 employees in that

situation Medicare would be the primary

and your employer coverage would be

secondary

if you all want someone that is under

the age of 65 and disabled off your

disabled for two years you're eligible

for Medicare and so if you

under 65 I'm disabled and you have a

group health plan and again it can be

typically it's going to be probably a

spouse or could be be a family member

and that employer has 100 or more

employees the group would be the primary

and Medicare would be the secondary same

scenario if it's less than 100 employees

than Medicare would be the primary in

the group would be the second day now

the last thing we'll touch on with this

is I mean if you are someone who has

been diagnosed with ESRD in stage renal

disease this oftentimes is a

irreversible kidney failure on dialysis

the way to that structure is the

employer plan once you become eligible

for Medicare the employer plan would be

the primary for the first 30 months and

after 30 months Medicare was then revert

into being or would become the primary

and that employer plan would then become

the secondary now a few important

aspects to keep in mind regarding all of

this is you know whichever coverage pays

first that primary payer they will pay

up to the limit of the coverage that you

have so they're there sometimes covers

within there that you have to be aware

of also the insurance that pays second

will only pay if there are costs that

the primary insurer did not cover so the

primary goes in the page of the bill the

secondary is not going to come in and

write you a check or anything once that

that bill is completely covered the

secondary payer also might not

necessarily cover all of the unpaid cost

and this includes one Medicare's and

secondary payer it's not necessarily

they will come in and cover all there

are many costs and many costs they do

not cover and a question that comes up

quite a bit with with us is for people

who are still working they'll ask you

know do I need to set up my Part D or if

my employer is going to be the secondary

or can I just have Part A and the answer

to that question is

is sometimes yes and sometimes no but

typically we advise that you speak to if

you're currently working you're whoever

deals with your benefits and ask them

that question because some companies

will in fact want you to pick up that

part being often times they do however

there are situations sometimes where you

know you just have to have your Part A

in place so that's something that

talking to your whoever deals with your

Human Resources at your company they can

oftentimes give you the proper guidance

on that so I want to thank everybody for

watching today if you have any questions

don't hesitate please as always give us

a call you can visit our website at

quote my Medicare org also I encourage

you please like and share the video if

you have any topics that you would like

to have covered please put in the

comments section asked a question put a

question in there we're always looking

for good topics to cover to help people

and and to better explain this stuff

sometimes it can be a little bit

confusing and so you know if you have

any questions that you want us to cover

please do just put it in there will be

glad to cover it and again I want to

just thank you for tuning in today and

wish you a get ready to have memorial

that's a very happy Memorial Day weekend

all the best thing