WI · guidance
Wis. ForwardHealth Online Handbook, Hospice, Topic #687
Medicare Advantage
Medicare services may be provided to dual eligibles or QMB-Only (Qualified Medicare Beneficiary-Only) members on a fee-for-service basis or through a Medicare Advantage Plan. Medicare Advantage Plans have a special arrangement with the federal
CMS (Centers for Medicare and Medicaid Services) and agree to provide all Medicare benefits to Medicare beneficiaries for a
fee. Providers may contact Medicare for a list of Medicare Advantage Plans in Wisconsin and the insurance companies with
which they are associated.
ForwardHealth has identified services requiring Medicare Advantage billing.
Paper Crossover Claims
Providers are required to complete and submit an Explanation of Medical Benefits form, along with provider-submitted paper
crossover claims for services provided to members enrolled in a Medicare Advantage Plan.
Reimbursement Limits
Reimbursement limits on Medicare Part B services are applied to all Medicare Advantage Plan copay amounts in accordance with
federal law. This may reduce reimbursement amounts in some cases.
Provenance
- Source
- www.forwardhealth.wi.gov
- Retrieved
- 2026-10-02
- Edition
- forwardhealth-hospice-2026-10-01
- Content hash
2904a3c810aaa62ec53deec65557f8b32949ba15112b66459e46c586bce164ca
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