When you become Medicare-eligible, you may be wondering whether your existing coverage coordinates with Medicare. Whether Medicare will pay primary or secondary depends on the other type of coverage you have.

First, it's common for Medicare beneficiaries to work past the age of 65. Most will have employer coverage. So, the major questions are whether you should keep your Medicare coverage while you have employer coverage and, if you do, which will pay first? This depends on how many employees are at the company.

When your employer has 20 or more employees, your coverage is creditable for Medicare. However, with fewer, than 20 employees, the coverage isn't creditable. In the latter scenario, you'll want to enroll in Medicare Part B to avoid penalties in the future.

With creditable employer coverage, Medicare is secondary and the group plan is primary. Whereas, with a group plan that is not creditable, Medicare is primary and the group plan is secondary.

In the circumstance where you're Medicare-eligible due to disability and have employer coverage, possibly through your spouse, the number of employees must be 100 or more for coverage to be creditable.

Medicare Advantage plans are considered primary coverage because they pay for your care instead of Medicare.

Other scenarios where Medicare is primary:
• You have Medicare and a Medicare Supplement (Medigap) plan
• You're dual-eligible for and have Medicare and Medicaid
• You also have coverage through FEHB, TRICARE, COBRA, retiree insurance, or tribal self-insurance

Situations when Medicare pays secondary:
• When you have a worker's compensation, liability, or no-fault insurance policy
• Active duty with TRICARE

As for Veterans benefits and Medicare, the two don't coordinate together. Veterans benefits work at veteran-approved facilities and Medicare works at civilian facilities.

Medicare also does not work with the Marketplace (a.k.a. "Obamacare"). If you have this coverage and receive subsidies, unfortunately, you will no longer qualify for them when you become eligible for Medicare. Additionally, it's illegal for an agent to try to sell you a Marketplace policy when you already have Medicare.e

All this information can seem overwhelming, but we are here to simplify it for you so you can make the best health care decisions. If you found this video helpful, please subscribe to our YouTube channel and join our Facebook Community Group!

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