Medicare Coordination

This is the “Medicare Coordination” section of the Employee Benefits FAQ Library.

When employees are eligible for Medicare and also have employer-sponsored health insurance, coordination rules determine which plan pays first.

For employers with 20 or more employees, the employer plan generally pays first and Medicare pays second.

Medicare may become the primary payer when employees work for smaller employers or when certain eligibility conditions are met.

Coordination rules depend on factors such as employer size and the type of coverage involved.

Employers generally cannot require employees to enroll in Medicare instead of the employer health plan. Employees may choose which coverage best fits their needs.

Employers should provide employees with information to help them understand how Medicare coordinates with employer coverage.

Disclaimer

This information is provided for general educational purposes and should not be considered legal, tax, or compliance advice. Employers should consult with qualified professionals regarding their specific compliance obligations.