Medicare - Who pays first - Publication 02179
Medicare – Who pays first – Publication 02179

My wife (I have full authorization filed for disclosure) is 69 and coverage by traditional Medicare (A and B) and also has group health insurance under a group of less than 20 employees.

***Thus Medicare pays first.

She had an accident and fractured her teeth requiring implant and new porcelain/ceramic pontics.

***Thus Medicare would pay for an accident, but not routine dental.

Claims were submitted to BCBS of Florida who says we should have first submitted the claim to Medicare.

***That’s correct, as Medicare pays first, then your group plan picks up the rest.

I have already paid directly for the services.

We reside in Florida and there were two D.M.D.’s (Doctor of Dental Medicine – same as DDS) involved in providing the services.

What do you recommend?

***I suggest that you just send the bill to Medicare.  Then resend to your group plan, once Medicare has paid.

If you want to double check, try calling the:

Benefits Coordination & Recovery Center (BCRC)—The company that acts on behalf of Medicare to collect and manage information on other types of insurance or coverage that a person with Medicare may have, and determine whether the coverage pays before or after Medicare. This company also acts on behalf of Medicare to obtain repayment when Medicare makes a conditional payment, and the other payer is determined to be primary


(Also, when we look at my wife’s profile online

***Do you mean her Medicare profile? www.MyMedicare.Gov?

it doesn’t list the supplemental carrier at all. How to we correct that?

***Send me your password privately and I’ll figure it out.  Medicare also has a customer service and live chat on the website.  They should be able to help you.

Related Pages Dental » Coverage for Dental Accidents under Medicare? »

Dual Coverage in General

40.3 – Other Coverage

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