Common use of Exceptions from Cost-Sharing Clause in Contracts

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; • American Indians as defined in section 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; • 21;‌‌  Pregnant women; •  Enrollees expected to reside for thirty (30) days or more in an institution; •  Enrollees receiving Hospice Care; •  American Indians as defined in section 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; •  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; • American Indians as defined in section 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; • 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 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; •  American Indians as defined in section 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; •  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; • 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.