How to Find Out If Medicare Is Primary

1.

Determine what type of Medicare coverage you have. Types of Medicare coverage include original Medicare Part A hospital insurance, Part B medical insurance, Medigap and Advantage Plans. Medigap is always secondary to the primary Medicare coverage. If you have a Medicare Advantage plan, skip to step 3.

2.

Call 1-800-MEDICARE. Inquire about the status of your Medicare coverage and whether other primary insurance exists.

3.

Contact the number on the back of your Medicare Advantage plan card. Inquire about whether your Advantage plan is your primary insurance coverage.

Tips and Warnings

  • Medicare plans are almost always primary to state Medicaid insurance.
  • COBRA and private insurance plans are typically primary to Medicare coverage.
  • Medicare is a government program created under the Social Security Act of 1965 to provide medical coverage to individuals 65 and older and certain disabled individuals. An individual may have Medicare and other insurance at the same time. A medical provider will need to ensure that Medicare is primary during the billing process if other insurance is present. If Medicare is secondary, the primary insurance must reject the claim or refuse to pay a portion of the claim before Medicare will consider providing coverage.