BENEFICIARY PROTECTIONS, PARTICIPATION, AND CUSTOMER SERVICE Sample Clauses

BENEFICIARY PROTECTIONS, PARTICIPATION, AND CUSTOMER SERVICE. ‌ 1. Choice of Plans and Providers: As referenced in section C.2, Medicare-Medicaid beneficiaries will maintain their choice of plans and providers, and may exercise that choice at any time, effective the first calendar day of the following month. This includes the right to choose a different Demonstration Plan, a Medicare Advantage Plan, to receive care through Medicare Fee-For-Service (FFS) and a Prescription Drug Plan, and to receive Medicaid services in accordance with the Commonwealth’s approved State Plan and any approved waiver programs.

BENEFICIARY PROTECTIONS, PARTICIPATION, AND CUSTOMER SERVICE. ‌ 1. Choice of Plans and Providers: As referenced in section C.2, Enrollees will maintain their choice of Demonstration Plans and may exercise that choice at any time. If a choice to enroll in a Demonstration Plan is made by the 12th of the month, Enrollment will be effective the first calendar day of the following month. Enrollment requests, including requests to change among Demonstration Plans received after the 12th of the month will be effectuated the first calendar day of the second month following the request. CMS and the State will monitor input received by the Ombudsman and Demonstration Plans about the time between beneficiary Enrollment requests and the effective date of enrollment. After the first year of the Demonstration, or when the State updates its eligibility systems, the State and CMS will also revisit the timeline for processing enrollments and, if necessary, will shorten the time period between the beneficiary’s Enrollment request and effective date of enrollment. All Disenrollments will be effective the first day of the month after the choice is made. A Disenrollment request is any action that terminates the Enrollee’s enrollment in the Demonstration, and includes, for example, the right to choose a Medicare Advantage Plan, to receive care through Medicare Fee-For-Service (FFS) and a Prescription Drug Plan, and to receive Medicaid services in accordance with the State’s approved State Plan and any approved waiver programs.

BENEFICIARY PROTECTIONS, PARTICIPATION, AND CUSTOMER SERVICE. 1. Choice of Plans and Providers

BENEFICIARY PROTECTIONS, PARTICIPATION, AND CUSTOMER SERVICE. 1. Choice of Providers: Consistent with requirements for Medicaid health homes, Medicare- Medicaid enrollees will maintain their choice of qualified Health Home Care Coordination Organizations, and may exercise that choice at any time. This includes the right to choose a different health home provider or choose not to receive any health home services. A change in health home provider will take effect the first of the following month in which the request is made. In addition, beneficiaries will maintain their choice of plans and providers, and may exercise that choice at any time. This includes the right to choose to continue to receive care through Medicare Fee-for-Service (FFS) providers and a Prescription Drug Plan, to choose a Medicare Advantage Plan, and to receive Medicaid services consistent with Washington’s approved Medicaid State Plan and applicable waiver programs.

BENEFICIARY PROTECTIONS, PARTICIPATION, AND CUSTOMER SERVICE. 1. Choice of Plans and Providers: As referenced in section III. C.2, Medicare-Medicaid beneficiaries will maintain their choice of plans and providers, and may exercise that choice at any time, effective the first calendar day of the following month. This includes the right to choose a different Participating Plan, or a Medicare Advantage Plan, or to receive care through Medicaid and Medicare Fee-For-Service (FFS) and a Prescription Drug Plan, a PACE site (where applicable), or an Independence at Home program (where applicable), and to receive Medicaid services in accordance with DMAS’ approved State Plan and any approved waiver programs.

BENEFICIARY PROTECTIONS, PARTICIPATION, AND CUSTOMER SERVICE. ‌ 1. Choice of Plans and Providers: As referenced in section C.2, Medicare-Medicaid beneficiaries will maintain their choice of plans and providers, and may exercise that choice at any time, effective the first calendar day of the following month. This includes the right to choose a different STAR+PLUS MMP, a Medicare Advantage plan, to receive care through Original Medicare and a Prescription Drug Plan (PDP), and to receive Medicaid services in accordance with the State’s approved State Plan services and any approved section 1115(a) demonstration and/or 1915(b) waiver. 2. Continuity of Care: CMS and the State will require STAR+PLUS MMPs to ensure that enrollees continue to have access to medically necessary items, services, and providers for the transition period as specified in Appendix 7. In addition, STAR+PLUS MMPs will advise enrollees in writing when they have received care that would not otherwise be covered at an in-network level. On an ongoing basis, and as appropriate, STAR+PLUS MMPs must also contact providers not already members of their network with information on becoming credentialed as in-network providers. Medicare Part D transition rules and rights will continue as provided for in current law and regulation.