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The rules that decide whether Medicare is the primary payer or secondary payer are complex. Individuals with two types of health insurance may benefit from comprehensive coverage.
Medicare usually covers most of your healthcare costs, but if you have other insurance coverage, it can act as a secondary payer for some of the costs.
In that case, Medicare is secondary, meaning a person could delay enrollment in Part B. Employer-based insurance is secondary if it is provided by an employer with fewer than 20 employees.
HRAs must follow "a variety of statutory rules and provisions" including the COBRA continuation coverage requirements, ERISA, and HIPAA. [16] HRA plans are considered "Primary Payers" subject to Medicare Secondary Payer (MSP) mandatory reporting requirements. There are significant penalties for failure to comply with the MSP reporting requirements.
The Medicare Secondary Payer provision of the ESRD program (also known as the ESRD Coordination Period) was enacted as part of the Omnibus Budget Reconciliation Act of 1981. MSP provides for a coordination of benefits period between Medicare and private health insurance plans for individuals entitled to Medicare solely on the basis of ESRD.
Lyndon B. Johnson signing the Medicare amendment (July 30, 1965). Former president Harry S. Truman (seated) and his wife, Bess, are on the far right.. Originally, the name "Medicare" in the United States referred to a program providing medical care for families of people serving in the military as part of the Dependents' Medical Care Act, which was passed in 1956. [7]