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Integrating Social Security and
Medicare for Cost-Effective Solutions
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Group Health Plans

   
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Many companies with group health plans are needlessly spending thousands – in some cases millions – of dollars each year by not taking advantage of the 1993 OBRA legislation which established Medicare as the primary payer for qualified non-working disabled lan participants.

Employees who have qualified for Social Security Disability Insurance (SSDI) benefits, and who are covered by a group health plan with 100 or more participants, qualify for Medicare to become the primary payer of their health claims.

If your company extends group health plan coverage beyond COBRA to long-term disability recipients and/or early retirees who are under age 65 and who have become disabled since separating from the company, you can:
  • Reduce future group health plan expenses approximately 71 percent for these individuals by establishing Medicare as primary payer.
  • Retroactively recover dollars already paid out inappropriately for these individuals by the group health plan as primary payer.
 
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