When an individual has both Medicare and Medicaid, which is considered the primary insurance?

When an individual is covered by both Medicare and Medicaid, Medicare is typically considered the primary insurance. This means that Medicare pays for healthcare services first, and any remaining costs can then be covered by Medicaid.

Medicare is a federal program primarily aimed at those who are 65 and older, as well as some younger individuals with disabilities. It provides coverage for specific healthcare services, including hospital stays, outpatient care, and some preventive services.

Medicaid, on the other hand, is a joint state and federal program designed to assist low-income individuals and families with their medical costs. It often serves as a secondary payer for those who qualify for both programs, filling in the gaps left by Medicare.

In cases where both insurances apply, the coordination of benefits typically favors Medicare because it is intended for a broader set of medical needs, while Medicaid is a safety net for those with limited financial resources. The other options presented, such as the Children's Health Insurance Program and TRICARE, do not apply to the scenario of Medicare and Medicaid dual coverage, as they target different populations and types of coverage.