Skip to Main Content

Search in HSP

The search's minimum of 4 and maximum of 60 characters. To search for information outside the provider manual or to find a specific provider communication by the assigned material number, use the search bar located at the top right corner of this page.

Please wait while we retrive the findings...

Search Results for:

Displaying 0 of 0 results...

Medicare Plus (Plan J or HJA)

Provider Type

  • Physicians
  • Participating Physician Groups (PPG)
  • Hospitals
  • Ancillary

If the member has conversion or Medicare Plus (Plan J or HJA) coverage:

  • Medicare is primary
  • The plan is always secondary

Medicare Plus (Plan J or HJA) is non-group coverage for Medicare beneficiaries who have lost eligibility through group or conversion plans.

Medicare Plus is available to subscribers and their spouses when:

  • They are age 65 or older.
  • Their previous group or conversion coverage has ended.
  • They are covered by both Parts A and B of Medicare (current employment does not affect eligibility for Medicare Plus).
  • They are not enrolled in another HMO plan through a Medicare HMO contract.

When the plan discovers that a Plan J or HJA member is not covered through both Parts A and B of Medicare or that the member is enrolled in another HMO plan through a Medicare HMO contract, the plan cancels the member's Plan J or HJA coverage.

Application for Medicare Plus must be made within 31 days of the member's last date of group or conversion coverage.

Last Updated: 07/01/2024