651 CMR 15.09

Coordination of Benefits

Year: 2026Length: 122 wordsOfficial source
A Member shall have access to Covered Benefits under the Plan only after said Member has exhausted all other prescription drug coverage, including all coverage available under the Member's Medicare Part D Plan or Creditable Coverage Plan. (1) For Members with coverage under a Medicare Part D Plan or Creditable Coverage Plan, the Plan shall coordinate benefits by providing Supplemental Assistance as established for the applicable Membership Category. (2) For Members who are not eligible for Medicare Part D coverage, but have another form of Prescription Drug Coverage, if a Prescription Drug is not a Covered Benefit under the other Prescription Drug coverage, but is a Covered Benefit under the Plan, the Plan will be the primary payor for that Prescription Drug.
651 CMR 15.09: Coordination of Benefits | Justis AI