Coordination Dates
Sam's DOB is 10/11/1968. MC is due to disability on 07/01/2022. UHC is effective 08/01/2022. The coordination date.
What is 08/01/2022.
Medicare part that covers hospitalization.
What is Medicare Part A.
This is the magic number for employee count when determining order of benefits.
What is 100 employees.
This is the magic number for employee count when determining the order of benefits.
What is 20.
This is always the rule when coordinating a self-pay policy and Medicare.
What is Medicare is always primary.
Grace has MC due to age 07/01/2021. Grace has group health plan effective on 01/01/2024. The coordination date.
What is 01/01/2024.
Medicare part that covers pharmacy.
What is Medicare Part D.
Melinda has MC due to disability. She is covered on her father's UHC plan thru active employment. The group size is over 500 employees. The carrier that is paying primary and reason code.
Bryan has MC due to age. He has a Humana policy thru his part-time employment. There are 21 employees. The carrier that is paying primary and reason code.
What is Humana over 65 greater than 20.
Lisa has MC due to disability. She works for Pizza Hut and the number of employees decreased on 03/01/2020 from 125 to 76. If the group maintains their current UNDER 100 status, when will Medicare become primary?
What is 01/01/2021.
Cindy has MC due to age on 05/01/2015. Cindy began working at McDonald's and has insurance thru her work effective 03/01/2023. The coordination date.
What is 03/01/2023.
COBRA, LTD, RETIRED, SURVIVING SPOUSE are all considered this.
What are inactive working statuses.
Daniel has MC due to disability. He is a domestic partner on a GHP plan through active employment. There are 200 employees. The carrier paying primary and reason code.
Gina has MC due to age. She has Aetna insurance thru her spouse's active employment. There are 16 employees. The carrier that is paying primary and the reason code.
What is Medicare, over 65 less than 20.
Suma has Medicare due to age and she works at Doggie Day Care. The number of employees increased from 15 to 21 on 06/18/2021. If the group maintains ABOVE 20 employees, when will the GHP become primary?
What is 10/30/2021.
Brandon has UHC effective 04/01/2021 - 06/30/2024. current. He has MC on 07/01/2024. The coordination date.
What is no coordination/no overlap.
Medicare Part that is administered by a commercial carrier.
What is Medicare Part C.
A member has MC due to disability. There are 32 employees. The carrier that is paying primary and reason code.
What is Medicare, disabled less than 100.
Dana has Medicare due to age. She is a domestic partner on a UHC policy thru active employment and the group size is 45. The carrier that is paying primary and the reason code.
What is Medicare, Domestic Partner.
Robert has MC due to disability and he works at Kitty Cat Company. The number of employees increased from 85 to 105 on 06/03/2022. If Kitty Cat Company maintains 105 employees, when will the GHP become primary?
What is 01/01/2023.
Alison has Medicare Part A and B effective 09/01/2024. She also has Medicare Part D effective 12/01/2024. Allison has UHC 02/01/2022-11/30/2024. The coordination period.
What is Medicare Part A and B 09/01/2024-11/30/2024. No coordination with Medicare Part D.
Medicare entitlement Reasons (There are four of them).
What is:
Disability, Age, ESRD and Dual Entitlement.
Pamela's date of birth is 04/14/1959. She began Medicare on 05/01/2012. She has UHC effective 03/01/2012. The coordination dates and entitlement.
What is Medicare due to disability 05/01/2012-03/31/2024 and Medicare due to age 04/01/2024.
Tim has Medicare effective 05/01/2019. Tim's date of birth is 11/23/1958. He has also UHC effective 04/01/2019. The coordination dates and entitlement.
What is MC due to disability 05/01/2019-10/31/2023, and MC due to age 11/01/2023
Donald has MC due to age and works for Music Unlimited. The number of employees decreased on 04/01/2023. When will Medicare become primary?
What is 01/01/2024.