Payment structure for the claim when the organization is having 20 or more employees

Group insurance plan is quite common among a number of organizations. This has mainly resulted due to the likely hazard which can arise over the employees of the organization. It is acting as a safeguard against the payment bills which can incur to the employees when they suffer from some health issue. One should be aware of the benefits which they can get to ensure that they don’t have to pay the healthcare costs.

Different policies of the Medicare Supplement Plans are divided based on the employee strength of the organization. It is also dependent on the way they are linked with the employee of other organization. This is dividing the insurance benefits as group insurance plans which are having 20 or lower employees, 20 or more employees and a large group insurance plan which have at least 100 employees. Each of them is having their own way of benefiting the employees for their healthcare costs.

Payment structure for the claim

In the case when your organization is having 20 or more employees than your group health plan will act as the primary payer. As a result, they are required to process your payment initially based on your coverage. Medicare will then process the remaining payment based on the coverage which they provide. Rest of the cost will then required to be bearded by the individual who owns the insurance.

Still, there are cases where the group health plan doesn’t pay. In that case, you can consult your doctor or healthcare provider. They will provide the bill to your Medicare for processing the secondary payment. Then the Medicare will process the payment based on what primary payer has paid and the coverage which they are providing. If some of the costs are not covered by both of them then you would be required to bear them.

One should be aware of the way they will be paid for the healthcare benefits. It will make them ready for the amount of coverage which they are having. Even they can be prepared for the costs which are not included in their coverage. This will be useful to them for ensuring that they keep certain amount ready with them for such situations.


Thus, we can say that there are different cases when your 2020 Medicare Supplement Plans might act as either primary or the secondary payer. One should be aware of them to ensure that they are able to process all the healthcare benefits which they possess. It will ultimately reduce the financial burden from them while they are taking the healthcare treatment.