Will Medicare pays first if I have declined my employer offered coverage?

Many different kinds of Medicare coverage’s are available for treating different diseases or health issues. It will help in reducing the financial burden from the individual. Each of the employers is also provided with Medicare Supplement Plans based on their organizational requirement. Normally they are taken in a group for all the people who are working in the organization.

These insurances are intended to provide the coverage not only to the individual but also to their family members. This makes the Medicare Supplement Plans quite popular and hence many organizations opt for them. The kind of plan which they have received depends on the kind of organization and the number of employees which it is having. Even the benefits will be provided to them accordingly.

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When you have not taken the group health plan coverage then Medicare will be acting as the primary payer. This will hold unless there are following conditions present.

  1. Your spouse is having coverage which is including you.
  2. The organization where your spouse works are having at least 20 employees.

Under the conditions discussed here, your Medicare Supplement plan will be acting as a secondary payer. In case if you are not taking the employer coverage plan while you were first offered, then you might not get a chance to join it later. Even if you take the coverage but drop the plan then also you will not be eligible to subscribe to the plan. There are also chances that you might be denied to be provided the coverage under below-mentioned conditions.

  1. Either your employer or the one of your spouse is offering retiree coverage.
  2. While working you and your spouse wasn’t enrolled in the plan.

If both of the conditions mentioned above are satisfied then there are likely chances that you might be denied to be provided with coverage. One should have a clear knowledge about the terms and conditions associated with the Medicare to ensure that they don’t suffer a loss in the future. They can then enjoy the maximum benefits by taking the respective Medicare coverage plan.


Thus, we can say that once you have declined your employee offered coverage, you can’t get it back. In that case, your Medicare Supplement plan will be acting as the primary payer unless few conditions which are discussed. There are chances that your spouse is having Medicare coverage in an organization having more than 20 employees. When this happens your Medicare will be acting as a secondary payer.