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Secondary Insurance for Medicare


Medigap policies are secondary insurance for Medicare. Because Medicare pays first, it is primary. But, Medicare doesn’t pay for everything. So, a Supplemental policy is beneficial to have in place to protect you from unexpected medical costs.

If you’re looking for the best secondary insurance with Medicare, it’s wise to become familiar with what each Medigap plan includes. The right policy for you depends on your present and future needs. We’re here to help you better understand the concept of Medigap as secondary insurance.

What is Medicare Secondary Insurance

Medicare Supplement plans are secondary insurance for individuals who have Part A and Part B. Because Medicare doesn’t cover everything, these policies are available to fill in the gaps. This helps reduce costs.

Most states offer 12 different plan options, with varying levels of coverage. Each plan is subject to federal regulations, ensuring that the benefits are the same regardless of the carrier. Also, not every carrier offers all Medigap plans.

The plans that provide more coverage tend to be more costly. When choosing a Medigap plan, consider the amount of coverage as well as the price.

What is Secondary Insurance to Employer Coverage

Medicare recipients who are still working might have a large employer group health plan. In this case, Medicare is secondary to the employer plan. It’s also possible to delay Part B if you reach age 65 and have creditable coverage through your employer. Yet, those without creditable coverage who delay enrollment into Part B could incur a Part B late enrollment penalty.

Primary vs. Secondary Medicare Plans

Medicare is primary to a Supplement plan because it pays first. After reaching the limit, your Medigap plan will pay second. Often, secondary insurance will not pay if the primary insurance doesn’t pay.

Medigap is not the only type of insurance that can be secondary to Medicare. For example, those with TRICARE For Life have TFL as their secondary plan. A series of rules known as the coordination of benefits decides the order of payment in each case. Sometimes, although rarely, there can be up to three payers.

How Secondary Insurance Works

When you have two insurance policies that cover the same kinds of risks, one of them is primary and the other is secondary. For example, suppose you have Medicare along with Medigap Plan G. Medicare will be your primary health insurance, and the Medigap plan is secondary. If you go to the doctor, Plan G will cover the remainder of the cost that you would otherwise be responsible for paying.

Supplemental vs. Secondary Insurance

Medicare Supplements provide extra coverage for what Medicare includes. Thus, your Medigap plan will always be secondary to Medicare. Supplemental insurance is available for what doesn’t get coverage.

For example, Part D is drug coverage, which is supplemental insurance. Dental, vision, and hearing policies are also available for purchase to supplement your existing coverage. Yet, these policies stand on their own and are not primary or secondary insurance. We understand this verbiage can be confusing since Supplements are secondary, rather than supplemental.

FAQs

What is a good secondary insurance to Medicare?
Medicare Supplement plans are a great way to fill in the gaps. In most states, there are 12 different options with varying levels of coverage. The plan that brings you the most value is the best plan for you.
How much is secondary insurance for Medicare?
Your Medigap premium rate depends on multiple factors, and it won’t be the same as your neighbor’s. One of these factors is how much coverage the plan offers. Yet, monthly premiums range from about $50 to over $300.
Is Medicare primary or secondary to employer insurance?
For those whose employer has more than 20 employees, Medicare is secondary. Yet, if your employer has fewer than 20 employees, the coverage isn’t creditable so Medicare becomes primary.
Can Medicare Part B be secondary insurance?
If your employer has over 20 employees and offers group health coverage, Medicare can act as your secondary insurance. You can also delay enrollment in Medicare if you have large employer coverage because it is creditable. Part B is also secondary for individuals with FEHB coverage.
Does secondary insurance cover the Medicare deductible?
With the exception of Plan A, all Medigap plans at least partially cover the Part A deductible. Plans K, L, and M involve cost-sharing, covering 50-75%. Yet, only Plans C, F, and High Deductible F cover the Part B deductible. But, these three plans are no longer available to those who are newly eligible.

How to Get Secondary Insurance for Medicare

Medicare Supplements can provide extra coverage as a secondary insurance option. If Medicare is your primary health insurance, a Medigap policy can safeguard against excessive costs.

To start comparing plans today, call the phone number above. As another option, fill out our online rate form. A licensed agent will prepare a premium rate comparison for you. We have helped countless individuals obtain the best secondary insurance for their Medicare, and we would be happy to do the same for you.

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Lindsay Engle

Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.

6 thoughts on “Secondary Insurance for Medicare

  1. I and my wife are 82 yrs old. We have no major medical problems at this time. We have medicare plus insurance but very little cash reserves. Is there a best way to insure against being wiped out by some catastrophic event? Or are we ok with medicare plus?

  2. I have medicare(I am a recent amputee). My prosthetist submitted my bill to mediare and they paid 80%. My wife’s work insurance will not pay the other 20% because they say the provider is out of network. Will I have to pay the 20%?

    1. Hi Frank! Unfortunately, yes, if the provider of the prosthetist is not within your secondary insurance network of doctors, you will have to pay the 20% coinsurance.

  3. BCBS HDHP High Plan through my employer is my Primary INS, Medicare A has been active since 3/31/19. I work full time. I had emergency surgery Sept 4th 2019 – I’m being billed for whatever BCBS is not paying and told I do not have Medicare A

    1. Hi Melody! If you’re being told you don’t have Medicare Part A, I would call Medicare directly to get that part figured out. If you actually do have Part A, that does still have a deductible of $1,364. You also have a high-deductible plan with your employer, with Blue Cross Blue Shield, it looks like your deductible may be around $2,500. What you’re being billed for may actually be the deductibles and out of pocket costs that’s left up to the beneficiary to pay. Without knowing more details, it’s hard to say what exactly you’re being billed for. There could also be a miscommunication between Medicare & BCBS. If you have a dedicated agent with BCBS, I would contact them as well to get this figured out ASAP. I hope this helps!

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