The short answer is yes. You can have both private insurance and Medicare.
There are two basic health insurance types: private health insurance and public health insurance. Private health insurance plans are sold by private insurance companies. Group health plans or employee health insurance plans are a good example of private health insurance.
On the other hand, public health plans are operated by the government. Examples include Medicare, VA benefits, and Medicaid. In some cases, you can have both private insurance and a public health insurance plan such as Medicare. If you have private insurance and Medicare at the same time, there’s a process that would be used to determine the primary insurance, i.e., the plan that pays first.
In some cases, Medicare may serve as the primary insurance, while in others, it may be considered the secondary health plan.
Employer Group Health Plan and Medicare
There are many situations where you can have Medicare and a private health plan. For example, if you have a group health plan through your employer, you can still enroll in Medicare when you become eligible. You can also have Medicare if you’re covered under your spouse’s group health plan and are eligible for Medicare.
To determine which insurance plan pays first, there are some factors that will be considered. First, if you have Medicare and you work in a company with 20 or more employees, the group health plan will serve as the primary insurance. However, if your company has fewer than 20 employees, Medicare will pay first.
If you qualify for Medicare due to a disability or ALS, your group health plan will be the primary insurance if your company has 100 or more employees. If your company has fewer than 100, Medicare will pay first.
In some situations, you may have a group plan after you retire. This is known as retiree coverage. If this happens, Medicare will be the primary insurance while the retiree coverage pays last.
TRICARE and Medicare
You can also have TRICARE and Medicare at the same time if you’re 65 or older and have Medicare Part B, or you have ESRD or ALS and are enrolled in Original Medicare. Dependents of active duty service members who have TRICARE can have both plans if they’re eligible for Medicare.
For people who have TRICARE and are on active duty, TRICARE will pay first. If you’re not on active duty, Medicare will pay first. Combining private health plans and Medicare may require additional help. For more information about what you can do with your Medicare options, call Swisher & Associates at 502-259-0780.
