Group Coverage vs. Medicare coverage

[Guest Victoria]

Our group coverage currently enrolls 150 employees plus dependents.One of our employees wishes to add her 48 year old husband who is currently on Medicare from disability. He has NOT lost his Medicare. They want to add him to the company coverage so that he will have RX. Will our company coverage automatically become primary? Is there any way around this?

[Guest nac]

Check your plan document - there should be an entire section on Medicare secondary provisions.

[Larry M]

It appears as if Medicare now requires your plan to become primary once he becomes covered by your plan.

Whether you can delay the enrollment of the individual or apply a preexisting condition limitation is another question.

These depend upon whether the individual is eligible to enroll immediately (because of HIPAA) or if the plan permits late enrollees to be deferred until they provide evidence of insurability satisfactory to the company.