If a person with Medicare also has Medicaid, which is the primary insurance?

In the scenario where a person is enrolled in both Medicare and Medicaid, Medicare is considered the primary insurance. This means that Medicare pays for covered services first, while Medicaid serves as a secondary payer. This arrangement allows Medicaid to cover some costs that Medicare does not, such as certain out-of-pocket expenses, copayments, and coinsurance amounts.

The rationale behind this hierarchy is rooted in how Medicare and Medicaid were designed to function. Medicare is primarily a federal program serving individuals aged 65 and older and some younger individuals with disabilities, while Medicaid is a state and federally funded program aimed at providing health coverage to low-income individuals and families. The coordination of benefits is structured this way to ensure that individuals maximize their health coverage capabilities.

In instances where both insurances are applicable, Medicare facilitating the primary coverage ensures a streamlined process for billing and payment, ultimately benefiting the patient by reducing their overall medical expenses.

The solutions involving private insurance or treating both plans equally would not accurately portray how these public programs interact under federal guidelines. Thus, it's clear that Medicare's role as the primary insurer in cases involving both Medicare and Medicaid enrollment is well established.