Understanding Medicare Overlap: How It Works & What It Means for You

Anyone who pays Medicare taxes in his life qualifies for Medicare in retirement. However, Medicare often overlaps with health insurance offered as part of a pension package to many retirees.

Identification

• Medicare overlap occurs when a person's private insurance plan covers the same procedures or services as Medicare covers.

Effects

• Medicare pays for care before other plans except for disabled individuals working for companies with more than 100 employees or those over 65 in a group plan from a company with at least 20 employees.

Other Exceptions

• There are some exceptions to Medicare coverage for certain conditions and situations, so people should check the list in Medicare's "Who Pays First?" guide for these specifics.

Tips

• Consumers should consider purchasing a Medigap plan rather than an extra health insurance policy that may overlap with many of the things Medicare covers. Medigap plans specifically cover what Medicare does not.

Warning

• Medicare does not know about other insurance plans unless a person informs Medicare on the questionnaire sent to new participants. Not telling Medicare about other plans could delay payment for medical care.