Common use of Eligibility for Medicare Clause in Contracts

Eligibility for Medicare. An individual shall be deemed eligible for Medicare when they have the option to receive Part A Medicare benefits. Medicare secondary payer regulations and guidelines will determine primary/secondary payer status for individuals covered by Medicare. A Member who is enrolled in Medicare has the option of continuing coverage under this EOC while on Medicare coverage. Coverage between this EOC and Medicare will be coordinated as outlined in Section IX. The Group is also responsible for providing KFHPWA with a prospective timely notice of Members’ ineligibility for Medicare Advantage coverage under the Group, as well as providing a prospective notice to its Members alerting them of the termination event. In the event the Group does not obtain Medicare Advantage coverage, the loss of Medicare drug coverage, other coverage options that may be available to the Member, and the possibility of late enrollment penalties if the Member does not apply for Medicare coverage within the required timeframe will also need to be provided.

Eligibility for Medicare. An individual shall be deemed eligible for Medicare when they have he/she has the option to receive Part A Medicare benefits. Medicare secondary payer regulations and guidelines will determine primary/secondary payer status for individuals covered by Medicare. A Member who is enrolled in Medicare has the option of continuing coverage under this EOC Benefits Booklet while on Medicare coverage. Coverage between this EOC Benefits Booklet and Medicare will be coordinated as outlined in Section IX. The Group is also responsible for providing KFHPWA Group Health with a prospective timely notice of Members’ ineligibility for Medicare Advantage coverage under the Group, as well as providing a prospective notice to its Members alerting them of the termination event. In the event the Group does not obtain Medicare Advantage coverage, the loss of Medicare drug coverage, other coverage options that may be available to the Member, and the possibility of late enrollment penalties if the Member does not apply for Medicare coverage within the required timeframe will also need to be provided.

Eligibility for Medicare. An individual shall be deemed eligible for Medicare when they have he/she has the option to receive Part A Medicare benefits. Medicare secondary payer regulations and guidelines will determine primary/secondary payer status for individuals covered by Medicare. A Member who is enrolled in Medicare has the option of continuing coverage under this EOC Benefits Booklet while on Medicare coverage. Coverage between this EOC Benefits Booklet and Medicare will be coordinated as outlined in Section IX. The Group is also responsible for providing KFHPWA with a prospective timely notice of Members’ ineligibility for Medicare Advantage coverage under the Group, as well as providing a prospective notice to its Members alerting them of the termination event. In the event the Group does not obtain Medicare Advantage coverage, the loss of Medicare drug coverage, other coverage options that may be available to the Member, and the possibility of late enrollment penalties if the Member does not apply for Medicare coverage within the required timeframe will also need to be provided.

Eligibility for Medicare. An individual shall be deemed eligible for Medicare when they have the option to receive Part A Medicare benefits. Medicare secondary payer regulations and guidelines will determine primary/secondary payer status for individuals covered by Medicare. A Member who is enrolled in Medicare has the option of continuing coverage under this EOC while on Medicare coverage. Coverage between this EOC and Medicare will be coordinated as outlined in Section IX. The Group is also responsible for providing KFHPWA with a prospective timely notice of Members’ ineligibility for Medicare Advantage coverage under the Group, as well as providing a prospective notice to its Members alerting them of the termination event. In the event the Group does not obtain Medicare Advantage coverage, the loss of Medicare drug coverage, other coverage options that may be available to the Member, and the possibility of late enrollment penalties if the Member does not apply for Medicare coverage within the required timeframe will also need to be provided.