I ran this by some of my group health buddies and no one knew. Figured I would toss this out to Medicare experts.
Group HDHP with $3,000 deductible. Medicare Part B deductible is $166.
Covered participant has group primary, Medicare B secondary.
Incurs $1,000 (par provider, adjudicated and repriced) outpatient claim. Submitted to carrier. Carrier applies $1000 towards deductible, pays nothing.
If claimant had only Medicare then Medicare would pay 80% less deductible.
But since there is a group plan in place, and the plan paid nothing, my premise is Medicare would likewise pay no
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Group HDHP with $3,000 deductible. Medicare Part B deductible is $166.
Covered participant has group primary, Medicare B secondary.
Incurs $1,000 (par provider, adjudicated and repriced) outpatient claim. Submitted to carrier. Carrier applies $1000 towards deductible, pays nothing.
If claimant had only Medicare then Medicare would pay 80% less deductible.
But since there is a group plan in place, and the plan paid nothing, my premise is Medicare would likewise pay no
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