While the benefits of enrolling in a Medicare plan are well-stated, many people have specific questions about the coverage and how it works with other types of health insurance. After all, it is common for individuals to be enrolled in Medicare and another type of health insurance or coverage at the same time.

Knowing the ‘coordination of benefits’ is necessary to get the most out of your health benefits while paying the least amount from your pocket. Are you looking for some information on the topic? If so, you’ve come to the right place. This Supplemental Medicare agency in Merrillville, Indiana is going to cover some of the key things you should know below.

What does it mean to have multiple payers?

When we say “payers,” we are talking about the different types of health insurance plans you might have. This includes Medicare, Medicare supplement insurance, employer insurance, or other forms of health insurance. When you have multiple insurance plans (or payers), there are specific rules about which insurance pays your medical bills first.

When you have multiple plans, your Supplemental Medicare agency in Merrillville, Indiana will use terms like “primary payer” and “secondary payer” to talk about which insurance pays first. The “primary payer” is the insurance that pays what it owes on your medical bills first. After the primary payer has paid its share, the “secondary payer” comes in and pays the rest of your bills. Sometimes, there can even be a third payer that pays after the first two, depending on the type of health coverage you have.

How does Medicare Supplement insurance fit in?

Medicare Supplement Insurance (also called Medigap) is designed to fill in the “gaps” in Original Medicare coverage. In other words, it pays for certain out-of-pocket costs that Original Medicare does not cover fully, like deductibles, copayments, and coinsurance.

When talking about who pays first (the coordination of benefits), Medigap usually acts as a secondary payer and pays after Medicare. It covers costs not paid by Medicare (the primary payer) and possibly other insurance if you have more than one additional coverage.

What happens if you have both Medicare and employer insurance?

Whether Medicare or your employer insurance pays first depends on things like your employment status and the employer’s size. Generally, if you are 65 or older and have insurance through your or your spouse’s current employment, the group health plan might pay first if the employer has 20 or more employees. Medicare would then be the secondary payer. If you need help sorting through the payment details, you can always consult with your local Supplemental Medicare agency in Merrillville, Indiana.

Why is the coordination of benefits important again?

Coordination of benefits is important because it ensures that your health care costs are split correctly between your multiple health insurance plans. It helps avoid payment delays and ensures you don’t get wrongly billed for services your insurance should cover. Knowing these rules can help you make better choices about your healthcare, and it can even save money on your health care costs down the road.

Looking for a Supplemental Medicare Agency in Merrillville, Indiana?

Understanding how Medicare works with other types of insurance can seem confusing. However, it’s necessary if you want to use your health care coverage in the best way possible. Are you ready to meet with a Supplemental Medicare agency in Merrillville, Indiana that can help you sort through your current coverage and find a plan that fills any gaps? If so, Senior Care Insurance Services (SCIS) is the place to visit. Our agents can review your situation and help you find a plan that aligns with your health coverage needs. Contact us today to get started.