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When Is Medicare Secondary?

Did you know that Medicare insurance becomes your secondary insurance when you belong to another health plan at work or get it from another source?

Many seniors who have turned 65 have enrolled in Medicare but continue to work. These seniors might also be covered by a health insurance policy under their family health plan. In this case they have health insurance coverage by more than one insurance carrier. When Is Medicare Secondary? In this instance Medicare will become the secondary insurance carrier and will only be responsible for paying the remainder of the bill. If the bill had been paid in full then Medicare pays nothing and does not need to be notified.

How Does Medicare Get Billed If They Are Your Secondary Insurance?

On your initial doctor visit you will be required to fill out a few medical history forms. You also will be asked to submit the name of your primary insurance carrier. This is the insurance company that will initially be billed for all of your health services. If you have Medicare as your secondary insurance company it is important that you note this on your information form. This will make your insurance carrier responsible for paying most of the bill. Medicare will be responsible for only paying the unpaid amount.

What If My Physician Will Not Bill My Secondary Insurance?

Filling out insurance forms takes a great deal of time. Many physicians will fill out only one bill per patient and submit it only to the initial insurance carrier. Wait until you get a notification from your primary insurance carrier informing you of the total amount of the bill they have paid. When there is a balance due be sure to make a copy of the paid bill. Attach this bill to a Medicare claim form requesting that their portion of the bill be paid.



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