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(On and Off Exchange)

Check HMO providers | Rx

(On and Off Exchange)

(Must have compatible plan)

(Must have compatible plan)

for Marketplace plans

through UnitedHealth One

through BCBSTX

through GeoBlue

972.245.0266 | 888.456.3467 972.245.2455 (fax) Mobile App

We get this question all the time. More and more people are working past age 65 nowadays, and for a variety of reasons some people choose to sign up for both Medicare and the group health coverage offered through their employer. But who pays first if you’re covered by both?

The answer is “it depends.” The general rule is that Medicare is primary if the company has fewer than 20 employees and the group plan is primary if there are more than 20 employees, but that’s not always the case. For instance, there’s a different cutoff point for people who have Medicare due to a disability, and there are special rules for people with End Stage Renal Disease (ESRD).

The good news is that Medicare has put together a handy guide that can help answer this question regardless of the situation. It’s called Medicare & Other Health Insurance: Your Guide to Who Pays First.

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