How am I covered under the large group health plan?

There are large numbers of organizations who are taking health plan for their employees. It is mainly done to ensure that their workplace is safe and even while accident they can cover up the costs incurred. This will help both the employees and the organization as a whole. Policies taken by the organization are divided into different section based on the number of employees and their employment status.

Each of the plans taken is handling different coverage’s for the family of the employee. One should be aware of the costs which are covered so that they can remain to prepare about the likely costs which they might have to pay. It will also help in reducing the financial burden on the individual when they are suffering from some kind of healthcare issue or accident.

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Under normal cases, most of the organization is having total employees lesser than 100. If the organization has at least 100 employees then they will be coming under a large group health plan. For the case of lesser employees than 100, you will be paid first by the Medicare. This will be paid if you are under 65 or you are having Medicare because of the disability (other than the end-stage renal disease).

There are also chances that employees who are fewer than 100 might join other employees to form a multi-employer plan. If at least one employee who is a part of a multi-employer plan is having 20 or more employees then Medicare Supplement Plan will pay second. When the total employees are at least 100 then it will come under a large group health plan.

In case, if you are covered under the large group health plan because of your current employment or employment of your family member then Medicare will pay second. When you go outside of this network then it is likely possible that neither the plan nor the Medicare might pay. One should call their employer plan before they are intending to go outside the network. It will help in getting a clear insight into whether their services are covered or not.


Thus, we can say that if you are having at least 100 employees then you can get covered under a large group health plan. In that case, your Medicare Supplement Plans will pay your bills second. Even if your family member is a part of such a network then you can get the benefit of the plan if you are their close family member. In case, the employer goes outside the network then plan and Medicare both might not cover up your healthcare costs.