How do I know whether my employer coverage or Medicare is primary?

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Last Update: June 22, 2007

  • If you are 65 or older and you have health insurance coverage through your or your spouse's current job with an employer that has 20 or more employees, your employer coverage is primary.

  • If you are under 65 and have a disability or are diagnosed with ALS and you have health insurance coverage through your or your family member's current job with an employer that has 100 or more employees, your employer coverage is primary.

  • If you have End-Stage Renal Disease (ESRD), your employer coverage from a current job is primary for the first two and a half years (30 months) after you are first eligible for Medicare Part A. Medicare becomes primary after that 30-month "coordination period" (even if you have not yet applied for Medicare and regardless of whether you are also entitled to Medicare because of age or disability).

      For more information on Medicare eligibility through ESRD, click on the link in the GO TO box.


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