Medicare Advantage (MA) will pay primary for any medically necessary Medicare-covered services –
According to the Department of Insurance and Financial Services (DIFS), Medicare will pay for Medicare-covered services to enrollees in Medicare Parts A and B who opt out of Personal injury Protection (PIP) medical benefits injured in an automobile accident and have no other available coverage.
- Because MA follows Medicare payment rules, MA plans will pay auto accident claims for those enrollees under those same circumstances.
- MA enrollees are entitled to Part A and required to be enrolled in Part B.
The member could be responsible for any services Medicare does not cover, such as transportation to and from medical appointments, vehicle modifications, case management services, residential treatment programs, long-term and custodial care, and replacement services.
Below are the summaries for Macomb's Medicare Advantage Summaries: