When Does Medicare Not Pay First?

When insurance companies have to deal with splitting the cost of care it can get a little bit nasty and confusing.  Insurance companies are notorious for not wanting to pay for things and this is especially true when other insurance companies are involved.  Medicare is a little different since it is run by the government so there are some situations where the other insurance will always come first.  These situations include:

You have Medicare; are still working; and are covered by your employer’s health insurance plan.  In this case your Medicare coverage will come after your employer’s play because you have access to an employer plan.  This coverage is going to come first because Medicare does not come before other plans that are available that you are eligible for.

You have Medicare, are retired, but your spouse is working and has a health plan that also covers you.  This is very similar to the first one because you have access to private health insurance coverage that other Medicare subscribers may not.  Medicare needs to take care of those that are otherwise not covered first.

You are injured on the job, in an automobile accident, or slip and fall at a shopping center (worker’s compensation, auto insurance or liability insurance may cover the cost of medical care related to the accident).  This is a way of Medicare making the private insurance companies step up to pay first.  Private insurance companies won’t argue because they do not want to start any disputes with the federal government.

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