US · guidance
CMS Pub. 100-05, ch. 5, § 30.5.3
State Law or Contract Provides That No-Fault Insurance Is Secondary to
Other Insurance
(Rev. 11550; Issued: 08 -12-22; Effective: 10 -13-22; Implementation:10 -13-22)
Even though State laws or insurance contracts specify that benefits paid under their provisions are
secondary to any other source of payment or otherwise limits portions of their benefits to payments
only when all other sources of health insurance are exhausted, Medicare does not make payment
when benefits are otherwise available. For example, a state provides $2,000 in no-fault benefits for
medical expenses and an additional $6,000 in no-fault benefits are available, but only after the
claimant has exhausted all other health insurance. In such cases, the Medicare law has precedence
over state laws and private contracts. Therefore, under these circumstances, Medicare makes
secondary payments only after the total no-fault benefits are exhausted.
History
(Rev. 11550; Issued: 08 -12-22; Effective: 10 -13-22; Implementation:10 -13-22)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5b21a2577600e1145c1d03e636d2a2098da80cd1489e3518d26922c210a19cd9
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