Primary insurance depends on employment status


Q. I have been receiving workers’ comp benefits since 1981. I have no Civil Service Retirement System benefits available, as I withdrew my contributions when I was separated from service. I am now 65 years old and have applied for Medicare. I have maintained my Blue Cross/Blue Shield insurance through the Office of Workers’ Compensation Programs. There is now a dispute as to whether that insurance is primary or Medicare is primary. The question seems to revolve around the following question: Am I “retired” or am I still employed? Do you know the answer?

A: Workers’ compensation is an income replacement program that is designed to continue until an injured employee recovers or dies, whichever comes first. If someone on workers’ comp recovers, he goes back on the agency rolls or, if he is eligible and wants to do so, retires. This tells me that you aren’t retired, a conclusion that is bolstered by the fact that you are not on OPM’s annuity roll and, therefore, not receiving an annuity. If I am right, then your Federal Employees Health Benefit plan carrier would continue to be the primary payer and Medicare secondary.


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Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to

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