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I am pretty familiar with the Medicare rules, but I am hearing that carriers and employers have had some choice. That conflicts with what I know about Medicare.
it seems the carriers have not followed them for groups under 20, and are now making that change, unevenly I asked an employee who works in benefits at an FMO about this under 20 employees primary/secondary question. They said one carrier is only restricting claims payments to Medicare as primary if the employee has enrolled in Medicare. Apparently there has been a disconnect about how Medicare says things work and how carriers have operated.
The other carrier's reps have emphasized that in 2016 groups under 20, the employees eligible for Medicare will get claims paid as if Medicare is primary.
It's not a big deal right now, but advising people covered under small groups under 20 could be very tricky.
Medicare's website does say the employer can ask for an exception about Medicare as primary. I don't know the circumstances where that would be granted. It seems automatic if the employer is part of a multi-employer group.
it seems the carriers have not followed them for groups under 20, and are now making that change, unevenly I asked an employee who works in benefits at an FMO about this under 20 employees primary/secondary question. They said one carrier is only restricting claims payments to Medicare as primary if the employee has enrolled in Medicare. Apparently there has been a disconnect about how Medicare says things work and how carriers have operated.
The other carrier's reps have emphasized that in 2016 groups under 20, the employees eligible for Medicare will get claims paid as if Medicare is primary.
It's not a big deal right now, but advising people covered under small groups under 20 could be very tricky.
Medicare's website does say the employer can ask for an exception about Medicare as primary. I don't know the circumstances where that would be granted. It seems automatic if the employer is part of a multi-employer group.
