Medicare will work with other plans and providers but does not necessarily make as many concessions when individual insurance plans are concerned.
Items to remember:
- If Medicare is the second payer will not pay all uncovered costs
- The primary payer usually will pay up to the limits of its policy
- For those with employer plans, you will need to enroll in Medicare part B before insurance will pay.
How Medicare Works With Workers’ Compensation
If you are still employed and are also eligible for Medicare there may come a time to understand the relationship between Medicare and Workers” Compensation. If you are inured on the job your employer provided Workers” Compensation insurance will be responsible for payment of medical and other related bills associated with the accident.
Medicare can't pay for medical or services that workers' compensation will pay for promptly (usually 120 days). However, if the workers' compensation insurer denies payment for your medical bills pending a review of your claim, Medicare may make a conditional payment. If your claim was denied you may submit Medicare proof of medical of claim, then Medicare may cover Medicare-covered items.
A good example of this is a pre-existing condition you had before you started your current job. If Workers; Compensation denied all or a portion of your new injury due to a pre-existing condition you may have coverage under Medicare. Medicare my pick up the excluded treatment, if the treatment or services is coverage under your Medicare plan. Medicare may pay its share for part of the doctor or hospital bills that workers' compensation doesn't cover.