Coordination of Medicare and BNY Mellon Medical Coverage

BNY Mellon Benefits Guide

If you or your covered spouse is enrolled in both Medicare and a BNY Mellon health plan, whether the BNY Mellon health plan or Medicare is the primary claims payer will generally depend upon your employment status. For a disabled employee enrolled in both Medicare and a BNY Mellon plan, Medicare would be primary.

Medicare's rules for qualified domestic partners with group health insurance coverage are:

Medicare pays first if a qualified domestic partner is entitled to Medicare on the basis of age and has group health plan coverage based on the current employment status of his/her qualified domestic partner.

Medicare generally pays second:

When the qualified domestic partner is entitled to Medicare on the basis of disability and is covered by a large group health plan on the basis of his/her own current employment status or the status of a family member.

For the 30-month coordination period when the qualified domestic partner is eligible on the basis of end-stage renal disease, and is covered by a group health plan on any basis.

When the qualified domestic partner is entitled to Medicare on the basis of age and has group health plan coverage on the basis of his/her own current employment status.

BNY Mellon's plans follow the non-duplication method when coordinating benefits—in cases where a BNY Mellon plan is determined to be the secondary coverage, BNY Mellon will pay only the difference between the amount normally reimbursed by BNY Mellon and the amount reimbursed by the primary coverage. This means if you are covered under two plans, you may not necessarily receive more benefits than you would if BNY Mellon were your only coverage.