Medicare eligible members must submit a copy of their Medicare card to MCHCP and the reason for Medicare coverage.
When Medicare-eligible members are no longer actively employed, Medicare becomes the primary plan. MCHCP medical plans coordinate benefits with Medicare Parts A and B. If MCHCP does not receive verification of Medicare Part B enrollment, the member is responsible for expenses Medicare Part B would have covered.
When Medicare is primary, members do not have to use network providers. As long as the provider accepts Medicare assignment, benefits will be paid at the network level. Services not covered by Medicare, such as hearing aids, are subject to preauthorization.
For claim questions, members should contact their medical plan or call the Medicare Coordination of Benefits Unit at 800-999-1118. For more details regarding Medicare enrollment, contact the local Social Security office or call 1-800-MEDICARE (1-800-633-4227).
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