I have multiple medical and prescription drug plans through different employers. How is it determined how much each plan pays and how much I pay?FAQs Cagegory: Medicare. Part D. */ ?>
Coordinating benefits between multiple plans follows standard nationally recognized rules for Coordination of Benefits. When Medicare is involved, the rules have been set by federal legislation which dictates when Medicare is the primary or secondary payer. Whether one plan is primary or secondary depends on the insured’s status and type of plan such as active employee or retiree; insured subscriber or dependent; Medicare or non-Medicare.
Additionally, each drug plan may have its own rules. Sometimes these rules conflict and it is not possible to receive payment from both plans. If you are currently coordinating multiple medical and prescription drug plan, please be aware that primacy rules may change and you may be subject to a copayment or coinsurance in which you weren’t previously subject to.
When you and/or your dependent enroll in Medicare Part B and are enrolled into the EUTF or HSTA VB Medicare Part D prescription drug plan as well as a non-EUTF group health plan (active employer plan), your Medicare Part D plan becomes secondary coverage to the non-EUTF group health plan. Medicare Part D coverage follows federally mandated secondary payer rules that may differ from other non-Medicare plans such as the EUTF or HSTA VB non-Medicare retiree prescription drug plan, and you may find that you have to pay a copayment even though you have dual coverage (more than one drug plan). Please contact SilverScript for more information on coordination of benefits and how their plan will coordinate with your non-EUTF active employer plan.
SilverScript will send you a notice if CMS identifies that you have other prescription drug coverage and/or other health insurance coverage. This notice will require you to review and correct any misrepresented information so that SilverScript may correctly pay your claims.