{"data":{"id":"us/42-cfr-411.204","jurisdiction":"us","citation":"42 CFR 411.204","heading":"Medicare benefits secondary to LGHP benefits.","body":"(a) Medicare benefits are secondary to benefits payable by an LGHP for services furnished during any month in which the individual—\n(1) Is entitled to Medicare Part A benefits under § 406.12 of this chapter;\n(2) Is covered under an LGHP; and\n(3) Has LGHP coverage by virtue of his or her own or a family member's current employment status.\n(b) Individuals entitled to Medicare on the basis of disability who are also eligible for, or entitled to, Medicare on the basis of ESRD. If a disabled individual is, or could upon filing an application become, entitled to Medicare on the basis of ESRD, the coordination of benefits rules of subpart F of this part apply.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT","Subpart H—Special Rules: Disabled Beneficiaries Who Are Also Covered Under Large Group Health Plans"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"3895d597adb9e09b02e9af9867fe923c06aa5c31a79b541deff884f1fb09d074","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-411.201","next":"us/42-cfr-411.206"},"notice":"GroundRules: Original legal text. Not legal advice."}