Medicare Advantage deductibles rule clarified

We want to make sure you’re aware that employer or union group-sponsored health plans may apply a deductible for Medicare Part B services when provided to a Medicare Advantage member at a federally qualified health center.

To clarify, if a health care provider treats a member who has coverage through an employer or union group-sponsored health plan, the member is responsible for the deductible if the plan applies a deductible to the service.

For more information, see Chapter 9, Sections 20 and 20.1, of the Medicare Managed Care Manual, produced by the Centers for Medicare & Medicaid Services.

If you have any questions, call Medicare Advantage Provider Servicing from 8 a.m. to 4:30 p.m. Monday through Friday at 1-866-309-1719.