US · guidance
CMS Pub. 100-05, ch. 2, § 30.1
Individuals Not Subject to MSP Provision
Medicare is not secondary under the MSP provision for disabled individuals:
• Who work or whose family member works for employers having fewer than 100
employees unless the GHP is a multi-employer plan in which at least one employer of
100 or more employees participates;
• Covered by an LGHP as a result of past employment (e.g., as a retired former
employee or as the spouse of a retired former employee) and whose coverage is not also
based on current employment status of their own or a family members current
employment status;
• Covered by a health plan other than an LGHP (e.g., one that is purchased by the
individual privately and not through an employer);
• Who have FEHB coverage under the Spouse Equity Act;
• Enrolled in Part B only; or
• Enrolled in Part A on the basis of a monthly premium.
History
(Rev. 11755, Issued:12-21-2022, Effective: 01-23-2023, Implementation: 01-23-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
39ba28a27dc4484cded11b265072c6fba9f6193ac78eb7aac5a3fd54abd13bfb
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