An insured individual who just turned 67 years old is still working and is a...

For individuals aged 65 or older who are still working and covered by an employer’s group health plan, Medicare’s role depends on the employer’s size. For employers with fewer than 20 employees (as in this case with 18 employees), Medicare is typically theprimary payer, and the group health plan is secondary. However, if the individual is actively working and enrolled in the group plan, the group plan is primary, and Medicare acts as thesecondary payer, covering claims not fully paid by the group plan, as per Medicare Secondary Payer (MSP) rules.

Option A: Incorrect. The group health plan is primary for active employees, not Medicare.

Option B: Correct. Medicare acts as the secondary insurer, paying claims not fully covered by the group plan.

Option C: Incorrect. Medicare does cover claims as a secondary payer, not denying them to prevent overinsurance.

Option D: Incorrect. Medicare does not require cancellation of group insurance; individuals can maintain both.

This question aligns with the Prometric content outline under “Medicare,” which covers Medicare’s coordination with group health plans.