J11 Part A Medicare Secondary Payer (MSP ... - Palmetto GBA

LiabilityAny source which provides payment based on legalliability for injuries, illnesses or damages toproperty.Liability includes, but is not limited to:• Auto Liability• Uninsured/ Underinsured Motorist• Homeowner’s Liability• Product Liability• Malpractice Insurance• Wrongful DeathMarch 201116DisabilityMarch 2011Medicare is secondary if an individual meetsall of the following criteria:• Entitled to Medicare on the basis of a disability (otherthan End Stage Renal Disease).• Has Large Group Health Plan (LGHP) coverage eitherthrough his/her active employment or that of a familymember.• The LGHP is offered by an employer of 100 or moreemployees.The disability provision is designed for individualswho are under age 65 and entitled to Medicare.17Working AgedMedicare is secondary if an individual meetsall of the following criteria:• Age 65 or older and entitled to MedicarePart A• Employed or has a spouse that is activelyemployed and is covered by an EmployerGroup Health Plan (EGHP) EGHP is offered by an employer of 20 ormore employeesMarch 2011186