Coordination of Medicare and Medicare Supplemental (Medigap)

480 - Coordination of Medicare and Medicare Supplemental (Medigap) Health Insurance Policies (Rev. 38, 04-09-04) B1-4607 The transfer of title XVIII claims information to Medicare supplemental insurers is required (under specified conditions) by §1842(h)(3)(B) of the Social Security Act, as enacted by §4081 of OBRA 87. • The physician or supplier involved must be a participating, physician or supplier, • The beneficiary must assign Medigap benefits to the physician or supplier, and • The policy named by the beneficiary must be a true Medigap policy to the exclusion of employer coverage and plans operated by labor organizations. Refer to Section 480.1 Exhibit for a list of Medigap insurers. Carriers and DMERCs shall continue with claim-based Medigap crossovers until they receive direction from CMS, via a future instruction, to do otherwise.