Which statement is NOT true concerning the relationship between group health insurance plans and Medicare for a business with more than 20 employees?

• A. Group health coverage is NOT available for workers over the age of 65
• B. Group health coverage is available to workers over the age of 65
• C. An active employee's group health plan is primary and Medicare is secondary, unless the employee chooses otherwise
• D. Group health coverage is available to an employee's spouse that also happens to be Medicare-eligible

Answer: (A)

In a business with more than 20 employees, the group health plan for an active employee is the primary payer, and Medicare usually pays secondary. This means the employer’s plan handles most benefits first, even when the employee is 65 or older, with Medicare kicking in after the group plan has paid. Medicare does not disqualify someone from group coverage at age 65; the plan can still cover the employee, and coordination between the two ensures there isn’t duplicate payment.

The statement that group health coverage is not available for workers over 65 isn’t true because age 65 and above does not remove eligibility for the employer’s plan; Medicare simply coordinates as the secondary payer in most cases. The other points align with how coordination of benefits typically works: an active employee’s plan is the primary payer and Medicare secondary, and an employee’s spouse who is Medicare-eligible can still be covered under the group health plan, with appropriate coordination between the two.