Individuals Not Subject to the Limitation on Payment

10.2 - Individuals Not Subject to the Limitation on Payment (Rev. 11755, Issued:12-21-2022, Effective: 01-23-2023, Implementation: 01-23-23) The MSP provision for working aged does not apply to: • Individuals enrolled in Part B only; • Individuals enrolled in Part A on the basis of a monthly premium; • Anyone who is under age 65. (Medicare is secondary to LGHPs that cover at least one employer of 100 or more employees for certain disabled individuals under age 65.); • Individuals covered by a health plan other than a GHP as defined above, e.g., one that is purchased by the individual privately, and not as a member of a group, and for which payment is not made through an employer; • Employees of employers of fewer than 20 employees who are covered by a single employer plan; • Retired beneficiaries who are covered by GHPs as a result of past employment and who do not have GHP coverage as the result of their own or a spouse's current employment status; • Individuals enrolled in single employer GHPs of employers with fewer than 20 employees; • Members of multi-employer plans whom the plan identified as employees of employers with fewer than 20 employees, provided the plan formally elected to exempt the plan from making primary payment for employees and spouses of employees of specifically identified employers with fewer than 20 employees; • Domestic partners who are given “spousal” coverage by the GHP; or • Former spouses who have Federal Employees Health Benefit (FEHB) coverage under the Spouse Equity Act