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Cost of Health Services Regulation Working Paper Series Medicare as Secondary Payer Health Insurance Regulation Working Paper No. I-14 Prepared by Christopher J. Conover with Emily P. Later Center

How to fill out i-14 medicare as secondary

How to fill out i-14 Medicare as secondary?

1. Obtain a copy of the i-14 form from the official Medicare website or your healthcare provider.
2. Begin by filling out your personal information such as your name, address, and social security number.
3. Provide details about your primary insurance coverage, including the policy number and effective dates.
4. Indicate the reason for submitting i-14 as secondary insurance and provide any necessary supporting documentation.
5. If applicable, fill out information about your employer or union group coverage.
6. Sign and date the form, ensuring all information is accurate and complete.
7. Review the completed form and make a copy for your records before submitting.

Who needs i-14 Medicare as secondary?

1. Individuals who have primary insurance coverage through an employer or union but require additional coverage can use i-14 as secondary insurance.
2. It is commonly used by Medicare beneficiaries who have health benefits from other sources, such as a spouse's employment or retiree benefits.
3. Applicants who meet the eligibility criteria and need Medicare benefits to supplement their primary insurance can opt for i-14 as secondary coverage.

For pdfFiller’s FAQs

What is i-14 medicare as secondary?

i-14 medicare as secondary refers to the process of submitting Medicare claims after other insurance carriers have adjudicated the claim.

Who is required to file i-14 medicare as secondary?

Healthcare providers who participate in Medicare are required to file i-14 medicare as secondary if there is another insurance carrier involved in the patient's claim.

How to fill out i-14 medicare as secondary?

To fill out i-14 medicare as secondary, healthcare providers need to include all the necessary information such as the primary insurance EOB, amount paid by primary insurance, and any deductible or coinsurance amounts.

What is the purpose of i-14 medicare as secondary?

The purpose of i-14 medicare as secondary is to allow Medicare to determine the payment they need to make after the primary insurance carrier has processed the claim.

What information must be reported on i-14 medicare as secondary?

The information that must be reported on i-14 medicare as secondary includes the Medicare Provider ID, primary insurance carrier information, EOB information, and any outstanding patient responsibility.

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