Common use of Exceptions from Cost-Sharing Clause in Contracts

Exceptions from Cost-Sharing. ‌ The following Enrollees or services are exempt from cost-sharing:  Enrollees expected to reside for thirty (30) days or more in an institution;  Enrollees receiving Hospice care;  American Indians as defined in section 2.12 who receive or have ever received a service(s) from an Indian Health Care Provider, or through IHS CHS referral from an IHS facility;‌‌  Emergency Services;  Family Planning;  Preventive services including:  Services with a rating of A or B from the United States Preventive Services Task Force, which includes tobacco use counseling and interventions (smoking cessation) services;  Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and  Preventive services and screenings provided to women as described in 45 CFR §147.130.  Services paid for by Medicare for which Medical Assistance pays the coinsurance and deductible;  Copayments that exceed one per day per Provider for non-preventive visits, and non- emergency visits to a hospital-based emergency department; and  Substance Use Disorder treatment services pursuant to Minnesota Statutes, §254B.03, subd. 2.

Exceptions from Cost-Sharing. ‌ ‌‌ The following Enrollees or services are exempt from cost-sharing:  Enrollees expected to reside for thirty (30) days or more in an institution;  Enrollees receiving Hospice care;  American Indians as defined in section 2.12 2.11 who receive or have ever received a service(s) from an Indian Health Care Provider, or through IHS CHS referral from an IHS facility;‌‌  Emergency Services;  Family Planning;  Preventive services including:  Services with a rating of A or B from the United States Preventive Services Task Force, which includes tobacco use counseling and interventions (smoking cessation) services;  Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and  Preventive services and screenings provided to women as described in 45 CFR §147.130.  Services paid for by Medicare for which Medical Assistance pays the coinsurance and deductible;  Copayments that exceed one per day per Provider for non-preventive visits, and non- emergency visits to a hospital-based emergency department; and  Substance Use Disorder treatment services pursuant to Minnesota Statutes, §254B.03, subd. 2.

Exceptions from Cost-Sharing. ‌ The following Enrollees or services are exempt from cost-sharing:  Children under age 21; Pregnant women;‌ Enrollees expected to reside for thirty (30) days or more in an institution;  Enrollees receiving Hospice care;  Care;‌ American Indians as defined in section 2.12 who receive or have ever received a service(s) from an Indian Health Care Provider, or through IHS CHS referral from an IHS facility;‌‌  facility; Emergency Services;  Family Planning;  Planning;‌ Preventive services including:  : (1) Services with a rating of A or B from the United States Preventive Services Task Force, which includes tobacco use counseling and interventions (smoking cessation) services;  ; (2) Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and  and (3) Preventive services and screenings provided to women as described in 45 CFR §§ 147.130.  Services paid for by Medicare for which Medical Assistance pays the coinsurance and deductible;  Copayments that exceed one per day per Provider for non-preventive visits, and non- non-emergency visits to a hospital-based emergency department; and  Substance Use Disorder Chemical dependency treatment services pursuant to Minnesota Statutes, §254B.03, subd. 2.

Exceptions from Cost-Sharing. ‌ The following Enrollees or services are exempt from cost-sharing:  sharing:‌ Children under age 21; Pregnant women;‌ Enrollees expected to reside for thirty (30) days or more in an institution;  Enrollees receiving Hospice care;  Care;‌ American Indians as defined in section 2.12 2.11 who receive or have ever received a service(s) from an Indian Health Care Provider, or through IHS CHS referral from an IHS facility;‌‌  facility; Emergency Services;  Family Planning;  Planning;‌ Preventive services including:  Services with a rating of A or B from the United States Preventive Services Task Force, which includes tobacco use counseling and interventions (smoking cessation) services;  Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and  Preventive services and screenings provided to women as described in 45 CFR §§ 147.130.  Services paid for by Medicare for which Medical Assistance pays the coinsurance and deductible;  Copayments that exceed one per day per Provider for non-preventive visits, and non- non-emergency visits to a hospital-based emergency department; and  Substance Use Disorder use disorder treatment services pursuant to Minnesota Statutes, §254B.03, subd. 2.

Exceptions from Cost-Sharing. ‌ The following Enrollees or services are exempt from cost-sharing:  • Enrollees expected to reside for thirty (30) days or more in an institution;  • Enrollees receiving Hospice care;  • American Indians as defined in section 2.12 who receive or have ever received a service(s) from an Indian Health Care Provider, or through IHS CHS referral from an IHS facility;‌‌  • Emergency Services;  • Family Planning;  • Preventive services including:  • Services with a rating of A or B from the United States Preventive Services Task Force, which includes tobacco use counseling and interventions (smoking cessation) services;  • Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and  • Preventive services and screenings provided to women as described in 45 CFR §147.130.  • Services paid for by Medicare for which Medical Assistance pays the coinsurance and deductible;  • Copayments that exceed one per day per Provider for non-preventive visits, and non- emergency visits to a hospital-based emergency department; and  • Substance Use Disorder treatment services pursuant to Minnesota Statutes, §254B.03, subd. 2.

Exceptions from Cost-Sharing. ‌ The following Enrollees or services are exempt from cost-sharing:  sharing:‌ Children under age 21; Pregnant women;‌ Enrollees expected to reside for thirty (30) days or more in an institution;  Enrollees receiving Hospice care;  Care;‌ American Indians as defined in section 2.12 who receive or have ever received a service(s) from an Indian Health Care Provider, or through IHS CHS referral from an IHS facility;‌‌  facility; Emergency Services;  Family Planning;  Planning;‌ Preventive services including:  : (1) Services with a rating of A or B from the United States Preventive Services Task Force, which includes tobacco use counseling and interventions (smoking cessation) services;  ; (2) Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and  and (3) Preventive services and screenings provided to women as described in 45 CFR §§ 147.130.  Services paid for by Medicare for which Medical Assistance pays the coinsurance and deductible;  Copayments that exceed one per day per Provider for non-preventive visits, and non- non-emergency visits to a hospital-based emergency department; and  Substance Use Disorder Chemical dependency treatment services pursuant to Minnesota Statutes, §254B.03, subd. 2.

Exceptions from Cost-Sharing. ‌ The following Enrollees or services are exempt from cost-sharing:  • Enrollees expected to reside for thirty (30) days or more in an institution;  • Enrollees receiving Hospice care;  • American Indians as defined in section 2.12 who receive or have ever received a service(s) from an Indian Health Care Provider, or through IHS CHS referral from an IHS facility;‌‌  facility; • Emergency Services;  • Family Planning;  • Preventive services including:  • Services with a rating of A or B from the United States Preventive Services Task Force, which includes tobacco use counseling and interventions (smoking cessation) services;  • Immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention; and  • Preventive services and screenings provided to women as described in 45 CFR §147.130.  • Services paid for by Medicare for which Medical Assistance pays the coinsurance and deductible;  • Copayments that exceed one per day per Provider for non-preventive visits, and non- emergency visits to a hospital-based emergency department; and  • Substance Use Disorder treatment services pursuant to Minnesota Statutes, §254B.03, subd. 2.