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October 17, 2006 |
BC-06-13 |
HHA-06-11 |
| To: | All Blue Cross Contracting Hospitals, Home Health Agencies, Hospice Agencies, End Stage Renal Disease Facilities
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| From: | Donna Bartee, Communications Representative Institutional Relations Blue Cross and Blue Shield of Kansas An Independent Licensee of the Blue Cross and Blue Shield Association |
| Subject: | Clarification Regarding Medigap Coverage |
The purpose of this newsletter is to clarify for providers that Medigap policies (including BCBSKS Plan 65/Disability Plan) have no financial responsibility when the member is enrolled in a Medicare Advantage Plan. As outlined in the Centers for Medicare & Medicaid Services publication titled 2006 Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare, a Medigap policy cannot pay for benefits that a person receives under a Medicare Advantage Plan or other Medicare Health Plan nor can it pay any cost-sharing under those plans. Even though Medigap coverage cannot pay for any benefits or balances, some members who are enrolled in a Medicare Advantage Plan have chosen to retain their BCBSKS Medigap coverage. Any claims that BCBSKS receives for these members will be denied. The denial notice to the member will state that the policy does not pay for any services when also enrolled in Medicare Advantage Plan.
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