90-Day SNF/NF Liability Period Sample Clauses

90-Day SNF/NF Liability Period. A. Beginning March 1, 2000, if federal approval is received by November 30, 1999; or July 1, 2000, if federal approval is received by March 31, 2000; or October 1, 2000, if federal approval is received by June 30, 2000; for any Recipient who is age 65 or older, is Non-Institutionalized and who is currently enrolled or enrolls in the HEALTH PLAN’s MA product while in a community setting, the HEALTH PLAN shall have financial responsibility for Nursing Facility services for 90 days. The 90 days begin at the time of the Enrollee’s date of admission to a Skilled Nursing Facility (SNF) or Nursing Facility (NF) or the effective date of enrollment, whichever is later. Both MA and Medicare covered days shall be counted toward the 90-day liability period. The 90 days shall be counted cumulatively. The HEALTH PLAN shall be responsible for paying any coinsurance for Medicare covered days during the 90-day liability period. The 90-day liability period may be applied to an individual more than once if the requirements of the 180-day Separation Period are met as specified in Section 4.7.4.
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