63 Plan. The term plan for Coordinatio n of Benefits purposes means a plan that provides benefits or services for medical care by or through any: • Group health plan, including group insurance and a self - insured group health plan; • Group practice or prepayment coverage; • Group service plan; • Method of coverage for persons in a group other than as shown in items 1, 2, and 3; or • Coverage that is required or provided by law . The term plan shall also include no - fault motor vehicle insur ance. Understanding Coordination of Benefits Primary Plan. If a plan is considered primary, that plan is responsible for paying first, in accorda nce with its benefits schedule, all claims for a covered person. Secondary Plan. If a plan is considered secondary, that plan is responsible for paying benefits, if any remain, af ter the primary plan has paid its share. Pre - Paid Plans. Pre - Paid plans (HMO s, EPOs, etc.) that require use of specific providers and pay benefits to only those providers will always be primary for dependents whose coverage by the Pre - Paid plan is because they are, or were, an employee. In such cases, this Plan will reimburse only copayments or expenses that remain on covered charges after the P re - Paid plan has paid benefits. Allowable Expense. Allowable Expense means any necessary, reasonable, and customary item or expense, at least a part of which is a covered expense under any o f the plans that cover the person for whom the claim is made. When the benefits from a plan are in the form of services, not payments, the service is considered to be both an Allowa ble Expense and a benefit paid. Claim Determination Period. Claim Determina tion Period means a calendar year. Coordination of Benefits with Medicare and Other Government Programs Medicare. Generally, anyone age 65 or older is entitled to Medicare coverage. Anyone under age 65 who is entitled to Social Security Disability Income Benefits is also entitled to Medicare coverage after a waiting period. Medicare has two parts: Hospital Insurance (Part A) and Medical Insurance (Part B). Part A covers in patient Hospital care and generally is available to all individuals over age 65 at n o cost. Part B covers doctor’s services, outpatient Hospital services and other medical supplies and is optional. You must pay a monthly premium for Medicare Part B. Althou gh you are eligible for Medicare Part A once you reach age 65, if you are an active participant, Part A coverage under Medicare is not automatic unless you have applied for Social Security benefits. Since Part A coverage is not automatic, you and your Spou se can register with Social Security for Part A when you reach age 65. You do not have to apply for Social Security payments (that is, actually retire), but you must apply and establish your entitlement to such benefits in order to be covered by Medicare. If you, your Spouse, or your Eligible Dependent Child are covered by the Plan and by Medicare, and you remain actively employed, your employer - sponsored group health plan will continue to provide the same benefits and the Plan will pay first (Primary) and Medicare will pay second (Secondary). If you are not actively employed, Medicare will be the Primary plan for any individual that is eligible for Medicare . Where Medicare is the Primary Plan, its benefits will be taken into account in determining any benef its to be paid under this Plan. The benefits of Medicare Parts A and B will be taken into account