Oxford New York Small Group Medicare Estimation Policy Reminder

Posted on October 14, 2020

Medicare Estimation is a process for determining the secondary payment when Medicare Part B is the primary payer. Medicare Estimation reduces the payment by the amount the primary Medicare Part B would have paid, by assuming the eligible member was enrolled in Medicare Part B. As previously communicated, July 1, 2020 Oxford began strictly enforcing their Medicare Estimation policy for all New York fully insured groups.

Oxford will be sending out a reminder letter to all New York Small Groups about this policy and to remind their impacted members to consider enrolling in Medicare Part B.

Click here for a sample of the Oxford Medicare Estimation reminder letter.

Note: Although this coverage change had widespread effects the most critical was for employer groups between 1-20 employees as under most circumstances those group policies are set up with Medicare as the primary payer for Medicare eligible members.