Coordination of Benefits | CMS Ensures claims are paid correctly by identifying the health benefits available to a Medicare beneficiary, coordinating the payment process, and ensuring that the primary payer, whether Medicare or other insurance, pays first
Coordination of Benefits Recovery Overview | CMS If a beneficiary has Medicare and other health insurance, Coordination of Benefits (COB) rules decide which entity pays first There are a variety of methods and programs used to identify situations in which Medicare beneficiaries have other insurance that is primary to Medicare
Medicare’s Coordination of Benefits “Medicare’s Coordination of Benefits” isn’t a legal document Official Medicare Program legal guidance is contained in the relevant statutes, regulations, and rulings
How Medicare Works with Other Insurance Coordination of benefits with Medicare depends on which insurance is considered “primary” and which is “secondary ” The insurance that pays first (primary payer) pays up to the limits of its coverage
Coordination of Benefits Rules Explained: 2026 COB Guide USA Updated CMS guidance confirms these rules protect Medicare trust funds and patient benefits while streamlining claims This guide pulls every key detail to give patients, providers, and billers clear, actionable information
42 CFR Part 423 Subpart J -- Coordination of Part D Plans With Other . . . (b) Coordination of benefits Part D sponsors must coordinate benefits with SPAPs, other entities providing prescription drug coverage, beneficiaries, and others paying on the beneficiaries' behalf for a period of 3 years from the date on which the prescription for a covered Part D drug was filled
Login | MRA - HHS. gov The information collected will be used to identify and recover past conditional and mistaken Medicare primary payments and to prevent Medicare from making mistaken payments in the future for those Medicare Secondary Payer situations that continue to exist