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Medicare Primary & Secondary Rules

Medicare Coordination Rules

Employee Status

Medicare Entitlement

Primary Plan

Secondary Plan

Active Employee age 65 or older

Medicare due to age

State and School Employees' Health Insurance Plan

Medicare

Spouse (age 65 or older) of Active Employee

Spouse has Medicare due to age

State and School Employees' Health Insurance Plan

Medicare

Retired Employee age 65 or older

Medicare due to age

Medicare

State and School Employees' Health Insurance Plan

Disabled Retired Employee under age 65

Medicare due to disability

Medicare

State and School Employees' Health Insurance Plan

Active Employee any age

Medicare due to ESRD

State and School Employees' Health Insurance Plan (1st 30 months)

Medicare (Primary after 30 months)

COBRA participant under age 65

Medicare due to ESRD

State and School Employees' Health Insurance Plan (1st 30 months)

Medicare (Primary after 30 months)

COBRA participant over 65 or disabled

Medicare due to age or disability

Medicare

COBRA

If you have COBRA when you become Medicare-eligible, your COBRA coverage ends on the date you enroll into Medicare. If you have Medicare before you are eligible for COBRA, you are allowed to keep the COBRA benefits.

If the Plan is primary at the time the 30-month coordination for ESRD begins, the participant must serve the entire 30 months before Medicare will be primary regardless if they become Medicare eligible for any other reason.

A surviving spouse or dependent of a retired employee or surviving spouse age 65 or older is assumed to have Medicare Part A and B regardless of that participant's Medicare eligibility. The Plan will calculate benefits assuming the participant has Medicare A and B.

If a retiree is retroactively approved for Medicare due to Social Security disability, the Plan will update their records to reflect Medicare as the primary coverage effective the date of Medicare eligibility. Subject to any federal restrictions and/or Plan conditions, the Plan will also refund any overpayment of premiums and reprocess claims to calculate benefits as secondary to Medicare not to exceed two years.