651 CMR, § 15.09

Current through Register 1536, December 6, 2024
Section 15.09 - Coordination of Benefits

A Member shall have access to Covered Benefits under the Plan only after said Member has exhausted all other prescription drug coverage, including all coverage available under the Member's Medicare Part D Plan or Creditable Coverage Plan.

(1) For Members with coverage under a Medicare Part D Plan or Creditable Coverage Plan, the Plan shall coordinate benefits by providing Supplemental Assistance as established for the applicable Membership Category.
(2) For Members who are not eligible for Medicare Part D coverage, but have another form of Prescription Drug Coverage, if a Prescription Drag is not a Covered Benefit under the other Prescription Drag coverage, but is a Covered Benefit under the Plan, the Plan will be the primary payor for that Prescription Drug.

651 CMR, § 15.09

Amended by Mass Register Issue 1327, eff. 12/2/2016.