When a member is 65 years old, their Medicare eligibility needs to be addressed in order to maintain eligibility as a Solidarity Member. There are a few paths that you can take regarding your Medicare options, that will impact your Solidarity Membership in different ways.
If you get Medicare Part A only. If you decide to only sign up for Medicare Part A, you are able to maintain your Solidarity Membership at the 65+ program cost. You would not be eligible for our Senior Discount, but you will maintain full Membership eligibility. Solidarity would simply be secondary on any services that Medicare would cover, and you would need to list Solidarity as secondary to Medicare and any other forms of medical insurance you may have at your providers' offices. This way they will bill Medicare first, and then send the Medicare EOB along with a bill for the remaining amount due to us for processing. There is no need to obtain a Medicare supplement if you are keeping your Solidarity Membership.
If you get Medicare Parts A and B. If you decide to sign up for Medicare Parts A and B, then you qualify for our Senior Discount pricing. As soon as you obtain your Medicare cards, please email us a copy of both the front and back of your cards so that we can update your eligibility on file, and apply the discounted cost to your Membership. Solidarity would still be secondary to any services that Medicare would cover, and you would need to list Solidarity as secondary at your providers' offices. This way they will bill Medicare first, and then send the Medicare EOB along with a bill for the remaining amount due to us for processing. There is no need to obtain a Medicare supplement if you are keeping your Solidarity Membership.
If you decide to decline Medicare coverage. If you decide to decline your Medicare coverage, it is your right to do so. You will still need to work with your social security office to obtain a denial letter stating that you do not have Medicare eligibility, so that we can continue extending you eligibility as a Solidarity Member. If we do not obtain this letter, then your bills will automatically process as ineligible, as our system will assume that you have Medicare coverage. If you decline Medicare coverage, then you would not qualify for the Senior Discounted pricing on your Membership, but you will maintain full eligibility with Solidarity once we obtain verification of Medicare denial. In this instance, you will keep Solidarity listed as primary at your providers' offices.
To obtain a senior discount quote and continue your Solidarity HealthShare Membership, please call our Service Experience Operations Team. Email a copy of your Medicare card front and back to support@solidarityhealthshare.org.
If you do not want to take advantage of the Solidarity HealthShare complement to Medicare, you can submit one of the following forms that best fit your Membership needs:
- Exclude primary member only, all other members remain on membership – complete Primary Member or Roll-Off Membership Change
- Exclude a member (other than the primary member) – complete Member Exclusion Request
- Cancel membership – complete Voluntary Membership Withdrawal
As a reminder, all membership changes need to be received by the first day of the month prior to when the requested change is to take effect.
Per our Sharing Guidelines (Section VII.C.12), needs do not qualify for Sharing to the extent that they are discountable by the Provider or are eligible to be paid by a third party or source such as insurance, Medicare, Medicaid, etc. For Solidarity Members age 65 and older, a medical bill must first be submitted to Medicare for processing. Once processed by Medicare, an itemized bill and an Explanation of Benefits (EOB) from Medicare can be submitted to Solidarity for Sharing. Even if Medicare denies a medical bill, an EOB showing the denial must still be submitted with an itemized bill. All medical needs processed by Solidarity must be eligible for sharing pursuant to the Sharing Guidelines and may be subject to the Annual Unshared Amount (AUA).