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Who Pays First

Who pays first if I have other health coverage?
If you have Medicare and other health coverage, each type of coverage is called a “payer.” When there’s more than one payer, “coordination of benefits” rules decide who pays first.

The “primary payer” pays what it owes on your bills first, and then your provider sends the rest to the “secondary payer” to pay. In some cases, there may also be a “third payer.”

Whether Medicare pays first depends on a number of things, including the situations listed in the chart on the next 2 pages. However, this chart doesn’t cover every situation. Be sure to tell your doctor and other health care providers if you have health coverage in addition to Medicare. This will help them send your bills to the correct payer to avoid delays.

Note: Paying “first” means paying the bill up to the limits of the payer’s Coverage. It doesn’t always mean the primary payer pays first in time.

Where to go with questions
If you have questions about who pays first, or if your coverage changes, call the Benefits Coordination & Recovery Center (BCRC) toll-free at 1-855-798-2627. TTY users should call 1-855‑797‑2627. To better serve you, have your Medicare number ready when you call. You can find your Medicare number on your red, white, and blue Medicare card. You also may be asked for additional information, like:

  • Your Social Security Number (SSN)
  • Address
  • Medicare effective date(s)
  • Whether you have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance) coverage

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More in this category: « Quick Look at Medicare