Medicare AdvantageAdministrativeMedium impact
Provider News - February 2018
Security Health Plan·WI·Provider News
We identified it
Jun 20, 2026
Summary
Security Health Plan added provider portal alerts for Medicare members with Medicaid assistance (QMB enrollees and dual-eligible members) who are not responsible for Medicare cost-sharing. Providers must verify Medicaid eligibility and cannot collect coinsurance, copayments, or deductibles from these members.
Action Required
Immediately: Train billing staff to check new provider portal alerts indicating QMB/dual-eligible status before collecting Medicare cost-sharing. Verify member Medicaid eligibility through Wisconsin state system or CMS HETS before billing. Stop collecting coinsurance, copayments, and deductibles from flagged members. Update billing workflows to recognize portal alert: 'This member has/had Wisconsin Medicaid assistance and is potentially not responsible for any Medicare cost sharing.'