Description:
Medicare should be the primary payer for Medicare eligible retirees for all non-service related conditions for services rendered at a military facility.

Policy Statement
When a retiree is covered by both Medicare and a retiree group health plan, Medicare pays primary.  However, when a retiree or veteran is treated at a VA facility for a non-service connected condition, a Federal veterans cost-shifting law requires that the VA bill the group health plan because Federal laws prohibit VA from billing Medicare.  Some plans have a Medicare carve-out provision for retirees, which makes Medicare primary when the retiree becomes eligible for Medicare and both Medicare and the plan offer the same benefits.  The payment on a Medicare eligible veteran should not exceed the Medicare deductible and coinsurance.

For dates of service on or after June 1, 1996, Blue Cross Blue Shield of South Carolina will provide coverage for military partnership provider claims under its insurance policies (subject to all policy terms and provisions).