O if you have medicare because youre 65 or over or because you have a disability other than end stage renal disease esrd medicare pays first o if you have medicare based on esrd cobra pays first medicare pays second to the extent cobra coverage overlaps the first 30 months of medicare eligibility or entitlement based on esrd. Generally if your employer has less than 100 employees medicare pays first if youre under age 65 or if you have medicare because of a disability sometimes employers with less than 100 employees join with other employers to form a multi employer plan. Medicare and other health benefits your guide to who pays first explains how medicare works with other kinds of insurance and who should pay your bills first it is not a legal document the official medicare provisions are contained in relevant laws regulations and rulings. Medicare other health benefits your guide to who pays first notice of availability of auxiliary aids services were committed to making our programs benefits services facilities information and technology accessible in accordance with sections 504 and 508 of the rehabilitation act of 1973 well take appropriate steps to make sure that people with disabilities including people