MEDICARE: Incentives Needed to Assure Private Insurers Pay Before Medicare

Abstract

One way to help control rising Medicare costs is to be sure that the program does not pay medical bills that other insurers should cover. Several times since 1980, the Congress has amended the Medicare statute to designate certain insurers as the primary payer-that is, to require them to pay medical claims ahead of Medicare. Insurers become the primary payer if they provide medical coverage to Medicare beneficiaries under certain employer group insurance plans, workers' compensation, or automobile and other liability insurance. Medicare then acts as a secondary payer; its claims processing contractors, usually themselves insurance firms, pay only what Medicare is responsible for after the other insurance pays. An estimated 1.5 million Medicare beneficiaries (about 5 percent) have other such insurance.

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Document Details

Document Type
Technical Report
Publication Date
Nov 01, 1988
Accession Number
ADA202063

Entities

Organizations

  • United States Government Accountability Office

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Congress
  • Contractors
  • Databases
  • Governments
  • Health Care
  • Health Services
  • Hospitals
  • House Of Representatives
  • Human Resources
  • Law
  • Medicare
  • Money
  • Motivation
  • New Jersey
  • Regulations
  • Social Security
  • United States

Fields of Study

  • Medicine

Readers

  • Economics
  • Government Contracting/Procurement.
  • Rehabilitation and Prosthetic Care for Military Service Members and Veterans with Limb Loss or Disability.