Medicare Advantage
Select Medicare Advantage from the left-side navigation.
Information will display if the beneficiary is currently enrolled in a Part C Medicare Advantage plan, also commonly referred to as a Medicare HMO or Medicare replacement plan. The Medicare Advantage plan section will also display historical MA plan information up to the previous four-years from the date of the search, depending on the selection made when the eligibility search was initiated.
This information is important as it will impact who is billed for services rendered. National Government Services, Inc. is a traditional fee-for-service Medicare payer and does not process Part C Medicare Advantage claims. If the beneficiary has selected an MA plan, you must contact the plan to determine billing and coverage.
The following information will be provided:
- Beneficiary Effective Date
- Beneficiary Termination Date
- Administering Insurance Company - if available the name of the private insurance company administering the MA plan will display.
- Plan Name – if available the specific plan name the beneficiary is covered under will display. Select the drop-down arrow to view additional information.
- Plan website
- Plan telephone number
- Contract Number – this information can be used on the CMS website to obtain the contact information and additional information for the MA plan.
- On the CMS website select the Research, Statistics, Data & Systems tab in the top navigation toolbar.
- Under the Statistics, Trends & Reports section select Medicare Advantage/Part D Contract and Enrollment Data.
- Select MA Plan Directory from the left side navigation, open the most recent file to view the most current information. You can use the Ctrl F to search the Excel file for the plan number.
- Plan Number
- Plan Option Code Description – information displayed in this column will provide additional details in regards to who is responsible for the services rendered.
Note: If the beneficiary is not currently enrolled in a Part C Medicare Advantage plan, or hasn’t been covered by an MA plan in the past four-years from the date of the search this panel will be blank.