Clear Care and Employer Group Medicare Plans
Clear Care, Our Medicare Advantage Plans
Group Health offers Clear CareŽ, our Medicare Advantage plans, to eligible Medicare members. Members can choose between Clear Care plans with or without prescription drug benefits (known as Medicare Part D).
Group Health Cooperative offers five Clear Care HMO plans in the following counties:
Group Health Options, Inc. offers one Clear Care PPO plan in the following counties:
Group Health processes and pays for all covered Medicare managed-care benefits for services rendered to eligible members. There is no need to bill Medicare directly.
Employer Group Plans and Medicare
Some members receive benefits from an employer group plan in addition to their Medicare benefits. In this case, Group Health, as the primary payer, coordinates with Medicare for all authorized care per the employer coverage plan and Medicare benefits. For more information, refer to the "Payment for Services" section of your provider agreement.
The Provider Manual is not intended for any use by any party other than as a resource for Group Health Cooperative's contracted providers in fulfilling their obligations under provider contracts. Group Health intends for the manual to be accurate for its intended purpose but doesnt guarantee accuracy. Providers should comply with the terms of their provider contracts and any legal requirements in the event of an inconsistency between the manual and a requirement in their provider contracts or the law.