Medicare Product definition

Medicare Product means any of the following:
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Medicare Product means one or more health benefits programs offered by Company to Groups or Individuals. The Medicare Product or Medicare Products applicable to this Agree- ment are set forth in the commission sched- ules attached as Exhibit C (“Commission Schedules”). References in this Agreement to CMS are limited to those Medicare Products that Company offers pursuant to one or more contracts with CMS.
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Medicare Product is any Medicare Advantage Plan, Medicare Advantage Prescription Drug Plan, or stand- alone Prescription Drug Plan that may now or in the future be offered to individual Medicare beneficiaries by BCBST. Medicare Product does not include any Medicare supplement insurance products offered by BCBST.
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Examples of Medicare Product in a sentence

  • Additionally, this Agreement shall be amended to exclude any Medicare Product or State-licensed entity specified by CMS.

  • In the event that Sponsor, pursuant to a separate agreement, delegates to Participating Provider certain Sponsor obligations under its agreement with CMS to provide a Medicare Product, Participating Provider shall perform such obligations as set forth in that agreement and in accordance with all applicable laws, regulations and government policies and pronouncements.

  • Participating Provider acknowledges that payments for Covered Services rendered to Members enrolled in a Medicare Product are, in whole or in part, derived from federal funds and receipt of such payment is subject to all laws and regulations applicable to recipients of such funds.

  • This Medicare Product Attachment shall terminate upon the termination of the Agreement and under the same terms and conditions specified in the Agreement.

  • Nothing in this Medicare Product Attachment shall be held to vary, alter, waive or extend any of the terms, conditions, agreements or limitations of the Agreement, including the Provider Manual, except as stated in this Medicare Product Attachment.

  • Upline and Agent are prohibited from obtaining any applications from prospective or current Medicare Product Enrollees for an open enrollment period prior to the first day of open enrollment, October 15th (or such other date established by CMS).

  • The Medicare Product includes those Coverage Agreements entered into, issued or agreed to by a Payor under which a Company furnishes administrative services or other services in support of a Medicare Product.

  • In addition to the limitations set forth in Section B(3) of Schedule D-1to Appendix D, Upline shall not institute legal proceedings against any applicant or enrollee of any Medicare Product for any cause arising out of the business transacted under this Agreement unless Aetna shall have been notified in writing of such action or the proposed action prior to or simultaneously with the institution of such legal proceedings.

  • Upline and its Agents are prohibited from charging any insured or applicant for a Medicare Product any fee or charge whatsoever.

  • If the Replacement has an effective date other than January 1st, a pro-rated amount of the “Replacement Rate” set forth on Schedule 1 will be paid, based upon the number of months the Medicare Product Enrollee will be enrolled in such Medicare Product within the initial calendar year.


More Definitions of Medicare Product

Medicare Product refers to those programs and health benefit arrangements offered by Health Plan or another Company in connection with one or more of the following Medicare product types that is administered, sponsored or regulated by the federal government (or any agency, department or division thereof) on its own or jointly with a State that administers or regulates such program or plan (each a “Medicare Product Type”): a non-Dual Eligible Special Needs Plan Medicare Advantage plan (“MA Plan”); a Medicare Advantage prescription drug plan (“MA-PD Plan”); a Dual Eligible Special Needs Plan (“DSNP Plan”); a Capitated Financial Alignment Demonstration (“MMP Plan”) plan or program (e.g., a plan or program adopted or established under the Affordable Care Act of 2010, to test new service delivery and payment models for people dually eligible for Medicare and Medicaid, including any regulations or CMS pronouncements and any future Attachments); or other Medicare Product Types. The Medicare Product includes those Coverage Agreements entered into, issued or agreed to by a Payor under which a Company furnishes administrative services or other services in support of a Medicare Product. The Medicare Product does not apply to any Coverage Agreements that are specifically covered by another Product Attachment to the Agreement. This Attachment applies only to the provision of health care services, supplies or accommodations (including Covered Services) to Covered Persons enrolled in the Medicare Product. Provider acknowledges that it will participate in each Medicare Product Type for which a Compensation Schedule(s) is attached to this Medicare Product Attachment.
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Medicare Product means the forms of medicare coverage under which medicare beneficiaries may obtain coverage from a risk- bearing entity, including a medicare advantage plan;
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Medicare Product means any of the following: a “prescription drug plan”, as such term is defined under Medicare Part D at 42 USC § 1395w-151(a)(14) (“Medicare Prescription Drug Plan”; a “Medicare supplemental policy”, as such term is defined under Medicare Part E at 42 USC § 1395ss(g)(1) (“Medicare Supplement Policy”); the health benefits coverage provided under Medicare Part C at 42 USC §§ 1395w-21 et seq. (“Medicare Advantage Plan”); or a Medicare Advantage Plan that provides qualified prescription drug coverage, as described under Medicare Part D at 42 USC § 1395w-101(a)(3)(C) (“Medicare Advantage‐ Prescription Drug Plan”).
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Related to Medicare Product

  • Child Care Program means a person or business that offers child care.

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).

  • Federal Health Care Program has the meaning set forth in 42 U.S.C. 1320a-7b(f).

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • FDA means the United States Food and Drug Administration.

  • Medical marijuana product means a product that contains cannabinoids that have been extracted from plant material or the resin therefrom by physical or chemical means and is intended for administration to a licensed patient, including but not limited to concentrates, oils, tinctures, edibles, pills, topical forms, gels, creams, and other derivative forms, except that this term does not include live plant forms.

  • Drug abuse means any pattern of pathological use of drugs that causes impairment in social or occupational functioning, or that produces physiological dependency evidenced by physical tolerance or by physical symptoms when it is withdrawn.

  • Respiratory care practitioner means a person who is

  • Tobacco product means any substance containing tobacco leaf, including but not limited to, cigarettes, cigars, pipe tobacco, hookah tobacco, snuff, chewing tobacco, dipping tobacco, bidis, blunts, clove cigarettes, or any other preparation of tobacco; and any product or formulation of matter containing biologically active amounts of nicotine that is manufactured, sold, offered for sale, or otherwise distributed with the expectation that the product or matter will be introduced into the human body by inhalation; but does not include any cessation product specifically approved by the U.S. Food and Drug Administration for use in treating nicotine or tobacco dependence.

  • Pre-Licensed Therapist means an individual who has obtained a Master’s Degree in Social Work or Marriage and Family Therapy and is registered with the BBS as an Associate CSW or MFT Intern acquiring hours for licensing. An individual’s registration is subject to regulations adopted by the BBS.

  • in vitro diagnostic medical device means any medical device which is a reagent, reagent product, calibrator, control material, kit, instrument, apparatus, equipment, software or system, whether used alone or in combination, intended by the manufacturer to be used in vitro for the examination of specimens, including blood and tissue donations, derived from the human body, solely or principally for the purpose of providing information:

  • Child care provider means a provider who receives compensation for providing child care services on a regular basis, including an ‘eligible child care provider’ (as defined in section 658P of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858n)).

  • Marijuana product means marijuana as defined in 50-32-101 and marijuana-infused products

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Antipsychotic medications means that class of drugs

  • Health care practitioner means an individual licensed

  • Pharmacy means prescribed drugs and medicines dispensed by a pharmacist and/or travel and allergy vaccines dispensed by a pharmacist or doctor.

  • Tobacco products means cigars, cigarettes, cheroots, stogies, periques, granulated, plug cut, crimp cut, ready rubbed, and other smoking tobacco, snuff, snuff flour, moist snuff, cavendish, ping and twist tobacco, fine-cut and other chewing tobaccos, shorts, refuse scraps, clippings, cuttings and sweepings of tobacco, and other kinds and forms of tobacco, prepared in such manner as to be suitable for chewing or smoking in a pipe or otherwise, or both for chewing and smoking.

  • Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.

  • Product means any deliverable under the Contract, which may include commodities, services, technology or software.

  • Marijuana products means concentrated marijuana products and marijuana products that are comprised of marijuana and other ingredients and are intended for use or consumption, such as, but not limited to, edible products, ointments, and tinctures.

  • Medicare Provider Agreement means an agreement entered into between CMS (or other such entity administering the Medicare program on behalf of the CMS) and a health care provider or supplier, under which such health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • medicinal product means any substance or combination of substances presented for treating or preventing disease in human beings or animals and any substance or combination of substances which may be administered to human beings or animals with a view to making a medical diagnosis or to restoring, correcting or modifying physiological functions in humans or in animals;

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.