Question

how does the Medicare program impact other payers ?

Answer 1

Payer is the type of coverage. Medicare program impacts other payers through the coordination of benefits. Primary payer covers the limit of the coverage. Secondary payers cover the benefit that is not covered under the primary payer. Sometimes Medicare provides services for other payer based on Conditional payment. For example,

• If one has both Medicaid and Medicare, then Medicare is the primary payer.
• If the elder who is in the group health plan, then Medicare is the primary payer and group health plan is the second payer.
• if the patient has COBRA coverage, then COBRA coverage has covered for the first 30 months, then Medicare-covered first.
• For veterans, medicare act as a primary payer.