Medicare and Disability

Medicare and Disability

The coordination of Medicare benefits with group health benefits has its own set of guidelines to address disabled employees and their spouses who are under age 65.

These guidelines were put in place to ensure that the Medicare payer rules apply equally to the disabled employee, spouse or dependent.

Under Social Security Disability Income (SSDI) guidelines, an individual will be automatically enrolled in Medicare Parts A and B prior to their 24th month of SSDI payments. Once enrolled in Medicare, the employer size dictates if Medicare or the group health plan is the primary payer of claims.

Please see the chart below to determine who will be the primary payer of claims.

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