COB Playbook

Determining Date of Retirement

If a patient cannot remember his/her, or his/her spouse’s, retirement date as it relates to coverage through an EGHP, follow the guidelines below as set forth by the CMS.

Scenario #1

Scenario #2

Scenario #3  If a patient or their spouse worked past the patient’s Medicare Part A entitlement date, but the patient/spouse retired less than five years ago and cannot recall their own or their spouse’s retirement date, we must obtain the retirement date from appropriate

 If a patient cannot recall his/her, or his/her spouse’s, date of retirement, but knows it occurred prior to their

 If a patient worked beyond his/her Medicare Part A entitlement date, had coverage under a group health plan during

Medicare Part A entitlement date as shown on his/her Medicare card, report the Medicare Part A entitlement date as the retirement date.

that time, and cannot recall his/her or their spouse’s exact retirement date, but knows it has been at least five years since retirement, enter the retirement date as five years retrospective to

informational sources; e.g.

the date of admission / treatments.

former employer or supplemental insurer.