Medicare

Medicare-eligible members must submit a copy of their Medicare card to MCHCP and the reason for Medicare coverage.

If Medicare coverage begins before age 65, members will receive a Medicare Disability Questionnaire. MCHCP must receive the completed questionnaire to update the member’s Medicare status.

Active employees and dependents do not need to enroll in Medicare Part B, except if Medicare-eligible solely due to End Stage Renal Disease (ESRD). When Medicare-eligible members are no longer actively employed, they should enroll in Medicare Part B and Medicare becomes primary.

Active Employees and Dependents with Medicare
MCHCP is primary and claims are submitted first to the MCHCP medical plan, then to Medicare. The exception is for active employees and dependents with Medicare solely due to End Stage Renal Disease (ESRD). Active employees in the Health Savings Account (HSA) Plan with Medicare due to ESRD can no longer be enrolled in the HSA Plan or contribute to their HSA. Any existing funds in the HSA can still be used for qualified medical expenses. The employee will be asked to choose a PPO plan. An active employee may remain in the HSA plan and contribute to their HSA when their covered dependent has Medicare due to ESRD.

Retirees, Survivors, Long-Term Disability and Terminated Vested Subscribers and Dependents with Medicare ^*
Members are automatically enrolled in the UnitedHealthcare (UHC) Group Medicare Advantage Plan for medical coverage and Express Scripts Medicare Prescription Drug Plan (PDP) for prescription drug coverage. MCHCP premium will be adjusted based on Medicare status. Do not enroll in an additional Medicare Advantage, Medigap, Medicare Supplement or another Medicare Part D plan.

Medicare-eligible Due to End Stage Renal Disease (ESRD)

Active Employees and Dependents with Medicare
When eligible for Medicare solely because of ESRD, the MCHCP medical plan will remain the primary plan during the first 30 months of Medicare eligibility. After 30 months, Medicare will become primary and MCHCP secondary.

Retirees, Survivors, Long-Term Disability and Terminated Vested Subscribers and Dependents with Medicare ^*
When eligible for Medicare solely because of ESRD, the MCHCP medical plan will remain the primary plan during the first 30 months of Medicare eligibility. After 30 months, the Medicare-eligible member will be automatically enrolled in the UnitedHealthcare (UHC) Group Medicare Advantage Plan for medical coverage and Express Scripts Medicare Prescription Drug Plan (PDP) for prescription drug coverage. The member is responsible for notifying MCHCP of their Medicare status. Do not enroll in an additional Medicare Advantage, Medigap, Medicare Supplement or another Medicare Part D plan.

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).

* - MCHCP members who are employees of a state-sponsored college or university covered under the Plan should check with their employer to see if MCHCP retiree coverage is included as a benefit to employees.