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How Your Bills Get Paid if You Have Other Health Insurance
Sometimes your other insurance pays your health care bills first and the Original Medicare Plan pays second. Other insurance that must pay first includes:
- employer or union group health plan coverage when coverage is based on your or a family member's current employment,
- no-fault insurance (including automobile insurance),
- liability insurance (including automobile insurance),
- black lung benefits, and
- workers' compensation.
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It's important that you tell your doctor, hospital, and pharmacy that you have other insurance so they know how to handle your bills.
In some cases, if the insurance that is supposed to pay first doesn't pay promptly, the Original Medicare Plan may make a "conditional" payment. This means it must be repaid to Medicare when a payment is made by the insurance that is supposed to pay first.
If you are in the Original Medicare Plan and you have questions about who pays first, or you need to update your other health insurance information, call the Coordination of Benefits Contractor at 1-800-999-1118. TTY users should call 1-800-318-8782. For more information, visit www.medicare.gov on the web and view the booklet "Medicare and Other Health Benefits: Your Guide to Who Pays First" or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
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(Primary Source: Centers for Medicare and Medicaid Services - Medicare and You Handbook 2007. This content may have been added upon by Q1Group LLC to include further examples, explanations, and links.)
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Last updated on: 07/18/2008
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