Explain the guidelines for processing claims for patients that have both Medicare and Medicaid coverage. How is this process different than the process for Medicare beneficiaries that have Medigap insurance?

MEDICARE is a health insurance programme in United States that provides insurance for the American citizens that are 65 years of age and above. While MEDICAID is equally a health insurance programme controlled by both federal and State government of United States for persons of all ages whose income and resources are insufficient to pay for health care.

Some citizens are qualified for both Medicare and Medicaid( dual eligible beneficiaries) and when processing their claims, Medicare is processed first( primary payer) as it pays first while Medicaid pays later( secondary payer).

Medigap serves as a supplement to Medicare (also called Medicare Supplement). They fill the gaps found in Medicare and the plans are designed to work together.

In conclusion,for patients that HV both Medicare and Medicaid, Medicare pays first followed by Medicaid while in patients that have Medicare and medigap coverage, the both plan pays together.