Wiki Patient with Medicare Part B and commerical insurance in CA

[mieeyy]

I am working at FQHC and is instructed to bill Medicare as primary insurance because patient should not have Covered CA insurance when Medicare part B is active.
I am wondering if it is true, and what if patient has commercial insurance from work or patient brought it from the health plan? I think the commercial insurance will be primary insurance then.

 

[csperoni]

While Medicare is TYPICALLY primary, there are situations where Medicare would be secondary. For example, if someone is over 65 and still working for an employer with > 20 employees, then Medicare would be secondary. There are a lot of other nuances where Medicare could be secondary. The best way to determine if Medicare is truly primary is during the insurance verification process.