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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.
If a patient worked
beyond his/her
Medicare Part A
entitlement date,
had coverage
under a group
health plan during
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
the date of
admission /
treatments.
If a patient cannot
recall his/her, or
his/her spouse’s,
date of
retirement, but
knows it occurred
prior to their
Medicare Part A
entitlement date
as shown on
his/her Medicare
card, report the
Medicare Part A
entitlement date
as the retirement
date.
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
informational
sources; e.g.
former employer
or supplemental
insurer.