What happens to Juan Perez's employer-sponsored healthcare coverage when he enrolls in Medicare?

When an individual like Juan Perez becomes eligible and enrolls in Medicare, the primary rule that determines how healthcare coverage works is based on his employer's size and the type of coverage provided. In many cases, when a person is covered by both Medicare and employer-sponsored health insurance, Medicare often acts as the primary payer if the employer has fewer than 20 employees. This means that Medicare will pay first for any healthcare claims, and the employer's plan may then cover some of the remaining costs.

In the scenario where Juan is eligible for Medicare and still has employer coverage, if his employer has 20 or more employees, the employer insurance typically becomes the primary payor for claims, and Medicare acts as the secondary payor. However, in instances where the employer has less than 20 employees, Medicare is the primary payer.

Understanding these dynamics is crucial because it affects how medical bills are paid and how much out-of-pocket expenses an individual may incur. Therefore, Juan's enrollment in Medicare can result in Medicare becoming the primary payor, especially if the employer's insurance plan is small.

This context of the relationship between Medicare and employer-sponsored coverage clarifies why this option is the correct one in understanding how Juan's healthcare claims will be managed after he enrolls