Who pays first? Multiple insurances

While the usual case is no insurance or inadequate insurance, many older people have multiple insurance coverages. In this case, the issue really becomes one of paperwork management. The government publications are helpful for the who pays first question and the following website even has phone numbers.http://www.medicare.gov/publications/pubs/pdf/02179.pdf
So why care, as long as you know someone's paying? Because of the ongoing paperwork challenges of the health services payment process.
Usually, Medicare pays last but with COBRA, Medicare it seems may revert to primary insurer status. If you are presented with notice that another insurer should have been billed first, make sure you respond.

Call the insurance companies and follow along as an interested party to make sure that they handle the claims between them. If notices start getting sent to "collection", you may want to expand your calls and letters to the state insurance department to prevent personal harrassment. This situation also emphasizes the importance of having a list of insurance coverages if you are helping out an older person with his claims (I've learned this the hard way).