Primary vs Secondary Payers: The Coordination of Benefits and How Your Medical Bills Are Getting Paid
When Medicare is used with other health insurance, each type of coverage is called a “payer”. With more than one “payer”, we refer to a rule called the “coordination of benefits” to determine which one pays first, also known as the “primary payer”. As your medical bills come in, the primary payer will pay its coverage limit first, and the “secondary payer” will pay out whatever payment is left. In other words, the secondary payer only pays if the primary payer did not cover the full medical bill. If you have Medicare, Medicare Supplement, and are still covered under an employer-sponsored health insurance policy, you may have a third payer.
For help with finding out which is your primary, secondary, or third payer, call the Benefits Coordination and Recovery Center (BCRC) at 1-855-798-2627. Also, you can visit, https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/who-pays-first/which-insurance-pays.html. There, you can find your specific insurance situation and get more information on how your payments are getting paid.