You're likely to encounter multiple situations that you may see when you have to determine whether Medicare is primary or secondary, but the following are among the most common scenarios you may encounter, according to CGS Medicare's Vanessa Williams, who spoke during the Part B payer's March 21 webinar, "Medicare Secondary Payer: The Basics." Follow the first chart to find out when Medicare is typically primary, and use the second chart to determine when Medicare is usually the secondary insurer.