When you have Medicare and another type of insurance, Medicare is either your primary or secondary insurer. Use the table below to learn how Medicare coordinates with other insurances.

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Type of Insurance Conditions Primary Secondary
65+ with job-based insurance Fewer than 20 employees Medicare Employer
20+ employees Employer Medicare
Disabled job-based insurance 100+ employees Medicare Employer
100 or more employees Employer Medicare
Liability insurance Liability-related claims Liability Medicare
Unrelated medical claims Medicare Not applicable1
Retiree insurance Not eligible for Medicare Retiree Not applicable
Eligible for Medicare Medicare Retiree
Veterans Administration (VA) benefits Claim from VA facility VA benefits Not applicable2
Claim from non-VA facility Medicare Not applicable
COBRA Had COBRA before enrolling in Medicare Medicare Not applicable3
Had Medicare before becoming eligible for COBRA Medicare COBRA
Medicaid Eligible for Medicare Medicare Medicaid (payer of last resort)

1 Liability insurance only pays on liability-related medical claims.

2 VA benefits and Medicare do not work together. Medicare does not pay for any care provided at a VA facility, and VA benefits typically do not work outside VA facilities.

3 COBRA ends if you had COBRA before enrolling in Medicare.



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Note: There are separate rules for individuals who are Medicare-eligible due to End-Stage Renal Disease (ESRD).