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Coordination of Medicare And Other Health Benefits

Medicare and Group Health Insurance: People Disabled With End Stage Kidney Disease (ESRD) Or With ALS

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If you receive Medicare because of permanent kidney failure or ALS, your group health plan is the Primary carrier for the first thirty months of eligibility or entitlement to Medicare.

After thirty months Medicare is Primary.

In this situation it doesn't matter how many people the employer employs. It also doesn't matter whether you have the group insurance due to active employment or retiree coverage.

Examples:

  • You are covered under your former employer's plan as a disabled retiree, and you have been on Medicare 27 months. Your employer's health plan is Primary. Medicare is Secondary.
  • You are covered under your former employer's plan as a disabled retiree, and you have been on Medicare for 34 months. Medicare is Primary. Your employer's health plan is Secondary.
  • You are covered under your spouse's plan from his or her work, and you have been on Medicare 27 months. Your spouse's health plan is Primary. Medicare is Secondary.
  • You are covered under your spouse's plan from his or her work, and you have been on Medicare for 34 months. Medicare is Primary. Your spouse's health plan is Secondary.

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