Mark continues working after age 65 and is covered through his employer's group health plan. Which statement is TRUE?

• A. The employer plan pays primary
• B. Medicare pays first
• C. Medicare is ignored when employer plan exists
• D. Medicare is the secondary payer

Answer: (D)

When someone is age 65 or older and still employed with a group health plan, the group plan typically pays first and Medicare pays second. This coordination of benefits means the employer’s plan is primary, and Medicare serves as the secondary payer. In Mark’s situation, continuing to work with employer-based coverage fits that rule, so Medicare would pay after the employer plan has paid its portion. The statement that Medicare is the secondary payer is therefore true. There are rare exceptions (like a very small employer with 20 or fewer employees) where Medicare could be primary, but under the common scenario described, Medicare remains secondary.