 |
Code of Federal Regulations (Last Updated: May 6, 2024) |
 |
Title 42 - Public Health |
|
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
|
SubChapter B - Medicare Program |
|
Part 411 - Exclusions from Medicare and Limitations on Medicare Payment |
|
Subpart H - Special Rules: Disabled Beneficiaries Who Are Also Covered Under Large Group Health Plans |
§ 411.204 - Medicare benefits secondary to LGHP benefits.
Latest version.
-
§ 411.204 Medicare benefits secondary to LGHP benefits.
(a) Medicare benefits are secondary to benefits payable by an LGHP for services furnished during any month in which the individual -
(1) Is entitled to Medicare Part A benefits under § 406.12 of this chapter;
(2) Is covered under an LGHP; and
(3) Has LGHP coverage by virtue of his or her own or a family member's current employment status.
(b) Individuals entitled to Medicare on the basis of disability who are also eligible for, or entitled to, Medicare on the basis of ESRD. If a disabled individual is, or could upon filing an application become, entitled to Medicare on the basis of ESRD, the coordination of benefits rules of subpart F of this part apply.