Tips on the Mcare Refund Process

PAMED has received a number of inquiries on the Mcare Refund Process.  Here are some common issues that we have encountered.

When to go to the McareChoice website – The McareChoice website provides physicians and other health care providers with the opportunity to make payment choices on refunds that are designated as “claimed” in the second column of their refund itemization.  See “claimed” refunds below highlighted in red.  You do not need to go on the McareChoice website to make payment choices for refunds designated as “assigned” or not designated (blank).   Information about next steps to assure proper payment of refunds can be found in PAMED’s Quick Consult on the Mcare Refund Notice Letter.

Line number for a claimed refund – When you are making a payment choice for a “claimed” refund on the McareChoice website, you must enter the line number for the refund in Step 3 and then make your payment choice for that refund.  The line number for a “claimed” refund is found in the first column of your refund itemization.  See numbers highlighted in red below.  Do not enter the amount of the assessment paid or the refund amount.  Do not manufacture a line number if the refund is not numbered.  Payment choices for unnumbered refunds should not be made on the McareChoice website and will be invalid.

Undesignated refunds – The beginning columns of your refund itemization will only have information if the refund is designated as “claimed” or “assigned.”  Be sure not to miss refunds that are not designated as “claimed” or “assigned.”  In these cases, the first three columns will be blank and the information for the refund will begin in the fourth column (“titled year”).  See undesignated refunds below highlighted in red.

Payment of undesignated refunds – Mcare will automatically pay to you any refund for your coverage that has not been “claimed” or “assigned.” You do not need to go on the McareChoice website to ask Mcare to pay the refund to you.

Assignment of undesignated refunds – If you want an undesignated refund to be paid to someone who paid the assessment for you, you must assign the refund to that person or entity.  Assignments cannot be made on the McareChoice website.  PAMED’s McareRefund website has instructions on how to make an assignment.  You will need to contact the person or entity that paid the assessment for you. Both you and the assessment payor must complete paperwork for an effective assignment, and the assessment payor must report assignments to Mcare by the assignment deadline.

Legal right to refund payment – While you control how Mcare will pay refunds for your Mcare coverage, the settlement could not change any rights to the refund that your employer or someone else who paid the assessment for you may have to the refund – independent of the settlement agreement – for example as a result of your employment contract. PAMED has information on its McareRefund website to help you determine whether it is in your best interests to agree to payment of a claimed refund to the claimant or to assign an undesignated refund. This information can be found under Legal and Tax Issues. If you want legal or tax advice or representation, you should consult your attorney or other professional advisor. PAMED has contact information for attorneys who are willing to provide legal advice on these matters and to help you resolve disputes with your employer or other person or entity that believes it is entitled to a refund for your Mcare coverage.