Medicare Eligible Participants

If you are enrolled in Medicare, you must submit a copy of your Medicare card to MCHCP and the reason for your Medicare coverage. After your card is received in our office, you will receive an authorization to release information for Medicare form. This form enables our representatives to assist you with Medicare claims. Medicare must receive a copy of the authorization from MCHCP prior to discussing any claims problems with our representatives.

Benefits payable under MCHCP plans are subject to coordination of benefits with Parts A and B of Medicare. When you are no longer actively employed, Medicare becomes your primary payor for claims. Therefore, you must take both Parts A and B to maximize your coverage. If MCHCP does not receive verification of Medicare Part B, you are responsible for the claims amount Medicare Part B would have covered.

Medicare Part D is Medicare’s prescription drug program. Each year MCHCP’s prescription drug plan is evaluated by a third party to determine if it is creditable (considered equal to or better than Medicare Part D). You will receive notification of the outcome from MCHCP. If MCHCP’s plan is considered creditable, you do not need to enroll in Medicare Part D and will not be penalized if you sign-up for Part D at a later date.

Active Employees Covered by Medicare
If you are actively employed, your MCHCP plan is the primary plan for you and/or your dependents and Medicare is secondary.

Retired or Vested Subscribers Covered by Medicare
If you are a retired or terminated vested subscriber covered by Medicare while maintaining coverage through one of the MCHCP plans, Medicare is the primary payor and your MCHCP plan is secondary. When you and/or your spouse become Medicare eligible, you must notify MCHCP and submit a copy of your and/or your spouse’s Medicare cards. To reflect your and/or your spouse’s Medicare status, the cost of your MCHCP plan premium may be adjusted. Keep in mind that although the percentage amount contributed for retirees remains the same, the decrease in premium also means a decrease in the dollar amount contributed.

Members Eligible for Medicare Due to End Stage Renal Disease (ESRD)
If you or your dependent is eligible for Medicare solely because of end stage renal disease, your MCHCP plan is primary to Medicare during the first 30 months of Medicare eligibility. After 30 months, Medicare becomes primary and claims are submitted first to Medicare, then to your MCHCP plan.

Note: If you are enrolled in Medicare due to disability or end stage renal disease (ESRD), you must submit a copy of your Medicare card to MCHCP and the reason for your Medicare coverage. After your card is received, you will receive a Medicare Disability Questionnaire. You must submit the completed questionnaire to our office in order for your Medicare eligibility to be sent to your medical plan.

Medicare Coverage for Long-Term Disability Subscribers
If you are on long-term disability and eligible for Medicare, Medicare is your primary plan and your MCHCP plan is secondary.