Tonya has been diagnosed with kidney failure and has group accident and health insurance through her large employer. Which plan will be primary during the months following her diagnosis?

• A. Her employer's group accident and health plan
• B. Medicare
• C. Her spouse's plan
• D. COBRA continuation plan

Answer: (A)

When multiple health coverage options exist, the plan that pays first is the primary payer. For Tonya, the coverage that will pay first is her employer’s group accident and health plan because she has that group coverage as an employee at a large company. In most cases, a group plan provided by a current employer pays first for an active employee, and other coverages (like Medicare, a spouse’s plan, or a COBRA continuation) come second or later depending on eligibility and plan rules. So, during the months after her diagnosis, the employer’s group plan will handle the primary submission and payment of benefits.