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Provider Manual

Order of Benefit Determination

Last Updated on August 28, 2018

If covered expenses are incurred by a member who is eligible to apply for Medicare and for whom Medicare is primary, Security Health Plan will determine the benefits payable, if any, using the rules and regulations of Medicare in determining whether Medicare or Security Health Plan is primary. 

If Medicare is primary for a Medicare eligible member, the member is considered enrolled in and covered under Medicare Parts A & B, whether or not a member is actually enrolled in one or both parts of Medicare. 

To learn more about coordination of benefits and secondary payer, please visit https://www.cms.gov/Medicare/Medicare.html