Cost-sharing and Family Income. For MSC+ Enrollees’ total monthly cost-sharing must not exceed five percent (5%) of family income. (1) For purposes of this paragraph, family income is the total earned and unearned income of the Enrollee and the Enrollee’s spouse, if the spouse is enrolled in Medical Assistance and also subject to the five percent limit on cost-sharing as authorized by Minnesota Statutes, §256B.0631, subd. 1, (a)(6). (2) The MCO must provide to the Enrollee a notice, within five (5) days of adjudicating the claim that causes the total cost-sharing to exceed five percent (5%), for each month the Enrollee meets the five percent (5%) limit on cost-sharing.
Appears in 5 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
Cost-sharing and Family Income. For MSC+ Enrollees’ total monthly cost-sharing must not exceed five percent (5%) of family income.
(1) For purposes of this paragraph, family income is the total earned and unearned income of the Enrollee and the Enrollee’s spouse, if the spouse is enrolled in Medical Assistance and also subject to the five percent limit on cost-sharing as authorized by Minnesota Statutes, §256B.0631, subd. 1, (a)(6).a)(6).
(2) The MCO must provide to the Enrollee a notice, within five (5) days of adjudicating the claim that causes the total cost-sharing to exceed five percent (5%), for each month the Enrollee meets the five percent (5%) limit on cost-sharing.
Appears in 2 contracts
Samples: Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services, Contract for Minnesota Senior Health Options and Minnesota Senior Care Plus Services
