Traditional MedicareCoverageMedium impact
MMP 26-04: Plan First and Medicare-Eligible Beneficiaries
Michigan Medicaid - MDHHS·MI · Family Medicine, OB-GYN, Internal Medicine·Provider Bulletin
Effective date
Mar 1, 2026
We identified it
Jun 16, 2026
Summary
This bulletin clarifies payment responsibilities for Plan First beneficiaries who are also Medicare-eligible, effective March 1, 2026. It specifies different billing rules for QMB/Plan First, SLMB/Plan First, and Medicare Part A&B/Plan First beneficiaries, with Plan First only covering family planning services.
Action Required
Before March 1, 2026: Billing team must update patient eligibility verification procedures to identify Plan First beneficiaries who are also Medicare-eligible. Update billing system rules to ensure QMB/Plan First patients are not billed above Medicare and Medicaid payments combined. Train staff that Plan First only covers family planning services and beneficiaries may be responsible for non-covered services. Verify QMB status before billing to avoid sanctions.