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1993.11.10 :  Impact of Recent Change in Medicare Law

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Contact:  Bob Hardy
Wednesday, Nov. 10, 1993 
(202)  690-6145

Bruce C. Vladeck, Ph.D., administrator of the Health Care Financing
Administration, has announced that a recent change in the law makes
Medicare the primary payer of health care services for certain
disabled beneficiaries who have coverage under group health plans
of employers with 100 or more employees.  This relatively small
group of beneficiaries are those who, while not actually working,
are treated as employees by their employers.

"Congress enacted this change in the law to provide uniform rules
for implementing the Medicare Secondary Payer provisions for the
disabled and working elderly," Dr. Vladeck explained.

Primary health plans pay first on health insurance claims while
secondary health plans pay after the primary payer.  When Medicare
is primary payer it pays first on health insurance claims for
Medicare covered services.

"Medicare will continue to be the secondary payer for disabled
beneficiaries who are actually working, as well as the disabled
family members of workers," Dr. Vladeck said.

Some disabled individuals for whom Medicare is now primary payer,
may not have enrolled in Medicare Part B (Medical Insurance)
because their plans were the primary payers under previous law.

Effective August 1993, these individuals will be able to enroll in
Medicare Part B without the usual premium penalty assessed to
discourage delayed enrollments.

Large employers or their group health plans should contact local
Medicare carriers for additional information.