Individuals Not Subject to This Limitation Payment

350.5.1 - Individuals Not Subject to This Limitation Payment (Rev. 4, 10-01-01) Medicare is not secondary for: • Individuals entitled, or who would upon application be entitled, to Medicare under the ESRD provision that are not in the coordination period, i.e., individuals who have ESRD even though their current Medicare entitlement is on the basis of disability; • Individuals who are covered by an EGHP of employers of less than 100 employees, unless the EGHP is a multi-employer plan in which there is at least one employer of 100 or more employees; and • Individuals whose coverage by an LGHP is not based on either employment or a relationship to an employee, employer, or an individual associated with an employer in a business relationship. For example, Medicare is primary for a disabled individual who is covered under an LGHP as a retired former employee, and who does not meet any of the criteria in §30.1 or who is the spouse of a retired former employee.