15.12 HOW MUCH THE PLAN PAYS WHEN IT IS SECONDARY TO MEDICARE

Covered Expenses must first be submitted to Medicare.

It is important to remember that the Plan will not pay more than our “normal benefit payable,” which is the amount the Plan would have paid in the absence of Medicare coverage. If the Plan’s “normal benefit payable” and the benefit paid by Medicare are the same amounts, or if the benefit paid by Medicare is more than the Plan’s “normal benefit payable,” the Plan will not pay any additional benefits. The combination of the Plan’s “normal benefit payable” and the benefit paid by Medicare will never exceed what the Plan would have paid in the absence of Medicare coverage. For additional details, see the TEAMStar Retiree Booklet.