Medicare Secondary Payer Provision Sample Clauses

Medicare Secondary Payer Provision. If you become eligible for Medicare while covered under this Plan, please visit xxx.xxxxxxxx.xxx or contact your local Social Security office to learn about your eligibility, coverage options, enrollment periods and necessary steps to follow to ensure that you have adequate coverage. Members are urged to carefully review Part XIV. COORDINATION OF BENEFITS for more information about how this Plan works with Medicare.
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Medicare Secondary Payer Provision. When you become covered under Medicare and are still eligible and covered under this Plan, your coverage under this Plan will be primary and Medicare benefits will be secondary, but only to the extent required by law. In all other instances, such as when you turn 65 or become eligible for Medicare due to a disability other than End Stage Renal Disease (ESRD), your coverage under this Plan will be secondary to any Medicare benefits. In such circumstances, enrolling in Medicare when you are first eligible can maximize your benefits. When your coverage under this Plan is the primary payer, claims for Covered Services should be filed with us first. If you become covered under Medicare and are still eligible and covered under this Plan, the Subscribing Group may not offer, subsidize, procure or provide a Medicare supplement policy to you. Also, an employer may not persuade you to decline or terminate your coverage under this Plan and elect Medicare as the primary payer. When you turn 65 or become eligible for Medicare due to ESRD, you must notify your employer.
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Medicare Secondary Payer Provision. When you become covered under Medicare and are still eligible and covered under this Plan, your coverage under this Plan will be primary and Medicare benefits will be secondary, but only to the extent required by law. In all other instances, such as when you turn 65 or become eligible for Medicare due to a disability other than End Stage Renal Disease (ESRD), your coverage under this Plan will be secondary to any Medicare benefits. In such circumstances, enrolling in Medicare when you are first eligible can maximize your benefits. When your coverage under this Plan is the primary payer, claims for Covered Services should be filed with us first. a. Individuals with ESRD. If you become entitled to Medicare coverage because of ESRD, your coverage under this Plan is primary for 30 months beginning with the earlier of: i. the month in which you became entitled to Medicare Part A ESRD benefits; or ii. the first month in which you would have been entitled to Medicare Part A ESRD benefits if a timely application had been made.
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Related to Medicare Secondary Payer Provision

  • CFR Part 200 or Federal Provision - If Yes" Response to Above Attribute - Continued - 0 Subcontracting and Affirmative Steps for Small and Minority Businesses, Women's Business 1 Enterprises, and Labor Surplus Area Firms. Only respond to this question if you responded "Yes" to the attribute question directly above. Skip this question if you responded "No" to the attribute question directly above. (a) The non-Federal entity must take all necessary affirmative steps to assure that minority businesses, women's business enterprises, and labor surplus area firms are used when possible. (b) Affirmative steps must include: (1) Placing qualified small and minority businesses and women's business enterprises on solicitation lists; (2) Assuring that small and minority businesses, and women's business enterprises are solicited whenever they are potential sources; (3) Dividing total requirements, when economically feasible, into smaller tasks or quantities to permit maximum participation by small and minority businesses, and women's business enterprises; (4) Establishing delivery schedules, where the requirement permits, which encourage participation by small and minority businesses, and women's business enterprises; (5) Using the services and assistance, as appropriate, of such organizations as the Small Business Administration and the Minority Business Development Agency of the Department of Commerce ; and (6) Requiring the prime contractor, if subcontracts are to be let, to take the affirmative steps listed in paragraphs(1) through (5) of this section. Does Vendor certify?

  • HEALTH CARE PLANS ‌ Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.

  • CFR PART 200 AND FEDERAL CONTRACT PROVISIONS EXPLANATION TIPS and TIPS Members will sometimes seek to make purchases with federal funds. In accordance with 2 C.F.R. Part 200 of the Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (sometimes referred to as “XXXXX”),Vendor's response to the following questions labeled "2 CFR Part 200 or Federal Provision" will indicate Vendor's willingness and ability to comply with certain requirements which may be applicable to TIPS purchases paid for with federal funds, if accepted by Vendor. Your responses to the following questions labeled "2 CFR Part 200 or Federal Provision" will dictate whether TIPS can list this awarded contract as viable to be considered for a federal fund purchase. Failure to certify all requirements labeled "2 CFR Part 200 or Federal Provision" will mean that your contract is listed as not viable for the receipt of federal funds. However, it will not prevent award. If you do enter into a TIPS Sale when you are accepting federal funds, the contract between you and the TIPS Member will likely require these same certifications.

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