I am under 65 and on disability. I have part A and B original Medicare. I also am covered under my boyfriend health insurance as a domestic partner (have been for years). His insurance is primary as thousands of employees and Medicare also in has verified this every year.

Medicare has my group health insurance information (though it been sitting in pending status this year compared to previous years).

Medicare in the past has paid secondary (which is correct..no issue with this). I had surgery last month and then Medicare told me that they do not recognize - acknowledge my primary insurance through my domestic partner as we are not married. They paid the radiologist and pathology as primary without any eob from primary. They are denying the hospital portion (unrelated to this issue saying it related to my initial disability—which I have to write letter saying it is not).

My main question is does Medicare recognize coverage under a domestic partner insurance (premiums are the same whether we married or not). Is this something new?

Hi,

In order for coverage under an employer group health plan (EGHP) to be primary instead of Medicare, you must either be covered as an active employee or as a family member of an active employee. The term 'family member' is described in Social Security's operations manual (https://secure.ssa.gov/apps10/poms.nsf/lnx/0600620178) as a spouse, parent, or other family member, and the Medicare website (https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coord...) only says 'family member'.

I'm not an expert on this provision of the Medicare regulations, but nothing I found in the resource material refers to domestic partners as being family members. I can't give you a definite answer, though, so you may want to try checking with someone with more expertise in the laws governing Medicare.

Best, Jerry