This article is for utilization review and billing departments at the following facility types caring for our Medex members:
- Acute care hospitals
- Long-term acute care hospitals
- Rehabilitation hospitals
When a Medex member reaches day 85 of their inpatient hospital stay, facilities should notify us by fax. This helps us coordinate benefits between Medicare Part A and the member’s supplemental Medex plan before they reach the 90th day of a benefit period.
Why this is important: The first 60 days of an inpatient stay are covered by Medicare Part A. Beyond that period, Blue Cross Blue Shield of Massachusetts Medex plans cover an additional portion of the costs. Timely notification:
- Ensures a seamless transition to supplemental benefits before the member starts their new benefit period and helps us coordinate with Medicare.
- Facilitates discharge and care management planning.
What to do: Fax notifications to 1-617-246-4210 to help us coordinate effectively.
Resource:
Medex outline of Medicare Supplement Coverage (member document)
MPC_031626-1Q-1