MHBP and Medicare: Coordinating Your Benefits
MHBP Standard Option is the perfect companion to your Medicare coverage, offering additional benefits and protections that Medicare may not cover. So whether you are retired or still working, MHBP and Medicare Parts A & B work together to reduce your out of pocket costs for covered services.
1. MHBP Picks Up Where Medicare Leaves Off
If you are retired, MHBP generally pays 100% of the difference between what Medicare pays and the allowed amounts for covered medical services when you have Original Medicare (Parts A and B).¹ This includes paying Medicare’s cost-sharing, such as the per-admission hospital deductible, Part B deductible, and the coinsurance you would normally have to pay. We’ll also waive your Standard Option cost-sharing for services covered by both Medicare and MHBP.
2. MHBP Coordinates Your Medical Benefits
Coordinating benefits with Medicare has never been easier. For your convenience, when Medicare is your primary coverage we can automatically retrieve your paid claims from Medicare and process any remaining balances for covered expenses under your MHBP benefits.
3. MHBP Provides Prescription Drug Benefits
MHBP provides comprehensive prescription drug benefits that help you save on your medications. In addition, MHBP uses a formulary (drug guide), giving you more opportunity to maximize your benefits. You can choose generic or brand name medications, but you'll pay predictable low copayments when you use a generic medication. What's more, you have a choice of using a Network retail pharmacy or our convenient mail order drug program for many medications.
The mail order drug program can be used for most maintenance prescription drugs, and you can receive up to a 90-day supply of a covered medication for just one low co-payment. And, you can choose to pick up your 90-day supply at a CVS retail pharmacy, if one is available near you.
MHBP Provides Hearing and Vision Discount Programs ²
MHBP Offers Additional Dental and Vision Benefits ³
¹ The information provided here assumes that you are enrolled in MHBP Standard Option and Original Medicare (Part A and Part B) is your primary coverage. MHBP will waive your cost-sharing (deductible, copayments and coinsurance) for services covered by both MHBP and Medicare. MHBP will not waive your cost-sharing for prescription drugs. If you have a Medicare Advantage Plan, MHBP will not waive your cost-sharing. If you are enrolled in Value Plan, MHBP will not waive your cost-sharing.
² These benefits are not part of the FEHB contract, but are made available to all MHBP members at no additional premium. You cannot file a FEHB disputed claim about them. The fees you pay for these services do not count toward FEHB deductibles or out-of-pocket maximums.
³ These benefits are not part of the FEHB contract or premium, and you cannot file a FEHB disputed claim about them. The fees you pay for these services do not count toward FEHB deductibles or out-of-pocket maximums. The MHBP Dental Plan is underwritten by First Health Life & Health Insurance Company and Cambridge Life Insurance Company.