Question

when determining how medicare works with other insurance, if a patient is 65 or older, has group health plan coverage based on his or his spouses current employment, and the employer has 20 or more employees, a. medicare and the group health plan split the cost of care 50/50. b. the group health plan pays second, and medicare pays first. c. the group health plan pays first, and medicare pays second. d. medicare pays first, and the group health plan pays second.

Explanation:

When a patient is 65 or older, has group health plan coverage based on their or their spouse's current employment, and the employer has 20 or more employees, the group health plan is primary (pays first) and Medicare is secondary (pays second). This is because the employer - sponsored group health plan is considered the main insurance in such a scenario.

Answer:

C. the group health plan pays first, and Medicare pays second.