This course provides agents, brokers, account executives, account managers and benefit professionals an overview of Medicare estimation processes and the rules governing Medicare as a secondary payer. Participants will learn how to determine when Medicare is primary versus secondary, how to avoid compliance pitfalls, and the importance of communicating these rules to all potential enrollees to protect both beneficiaries and plan sponsors.
Learning Objectives: By the end of this session, participants will be able to
1. Explain the concept and legal foundation of Medicare Secondary Payer (MSP) rules.
2. Identify when Medicare is the primary or secondary payer in different scenarios.
3. Understand the Medicare estimation process for group health plans and liability claims.
4. Apply coordination of benefits principles to real-world situations.
5. Recognize key compliance and reporting obligations under MSP.