Thursday, June 3, 2010

What are the circumstance when Medicare is secondary.

Insurance Primary to Medicare - Circumstances under which Medicare payment may be secondary to other insurance include:

• Group Health Plan Coverage
o Working Aged;
o Disability (Large Group Health Plan); and
o End Stage Renal Disease;

• No Fault and/or Other Liability; and

• Work-Related Illness/Injury:
o Workers' Compensation;
o Black Lung; and
o Veterans Benefits.

NOTE: For a paper claim to be considered for Medicare secondary payer benefits, a copy of the primary payer's explanation of benefits (EOB) notice must be forwarded along with the claim form.

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