Common use of Medicare Secondary Payer Provision Clause in Contracts

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.