Medicare Eligibility: Who pays first?

Posted by Brandon Caplan on December 2, 2020 in Human Resources, Notices

Message to Employers with employees for whom Medicare is the primary payer PF Compass wants you to know some important rules for your Medicare-eligible employees. Eligible members are encouraged to enroll in Medicare in order to maximize their health plan benefits and minimize expenses. If your employer has an employee headcount of twenty or more employees, a commercial health plan is the primary payer. If your employer has an employee headcount of under twenty employees, Medicare is the primary payer. It’s important for eligible members to enroll in Medicare Once a member is eligible for Medicare as their primary payor, and if they are not enrolled in Medicare, health plans will coordinate benefits with their group coverage and pay benefits as though they were enrolled in Medicare Part B. This means that benefits will be paid by subtracting the amount that Medicare would have paid (usually 80 percent of...