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July 7, 2020

New Provider Tips – Medicare Part C and D Eligibility

For providers new to Medicare, please read the tips below to help with your questions on checking Medicare Part C and D eligibility through myCGS.

The Plan Coverage tab provides information regarding the beneficiary's enrollment under Medicare Advantage (MA) and Part D contracts and/or MA Managed Care Plans (Part C contracts) that provide Part A and B benefits for beneficiaries enrolled under a contract.

When retrieving the MA Plan or Part D information, myCGS may provide the following for these contracts:

  • Plan Type
  • Enrollment Date
  • Disenrollment Date
  • Contract Number or Plan Benefit Package ID
  • Plan Name
  • Address
  • Phone Number

Screenshot

Please note, when myCGS indicates that a beneficiary has coverage through a non-Medicare entity (MA or Medicare Drug Benefit plans) the inquiring provider should always contact the non-Medicare entity for complete beneficiary entitlement information. You may also contact the beneficiary for a copy of that plan's card for your records.

Please refer to the myCGS User ManualPDF be for more eligibility information and further guidance.

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