Common use of Limitation on Out-of-Pocket Costs Clause in Contracts

Limitation on Out-of-Pocket Costs. Notwithstanding any provision in this Agreement to the contrary, Dual Eligible Beneficiaries enrolled in Health Plan’s SNP(s), Health Plan agrees that it may not impose Cost-Sharing that exceeds the amount of Cost-Sharing that would be permitted with respect to such individual pursuant to the State Medicaid Plan if the individual were not enrolled in the Health Plan’s SNP(s). (Sec. 5.11.4)

Limitation on Out-of-Pocket Costs. Notwithstanding any provision in this Agreement to the contrary, Dual Eligible Beneficiaries enrolled in Health Plan’s SNP(s), Health Plan agrees that it may shall not impose Cost-Sharing that exceeds the amount of Cost-Sharing that would be permitted with respect to such individual pursuant to the State Medicaid Plan if the individual were not enrolled in the Health Plan’s SNP(s). (Sec. 5.11.4SMAC Requirements Matrix #4)

Limitation on Out-of-Pocket Costs. Notwithstanding any provision in this Agreement to the contrary, Dual Eligible Beneficiaries enrolled in Health Plan’s SNP(s), Health Plan agrees that it may shall not impose Cost-Sharing that exceeds the amount of Cost-Sharing that would be permitted with respect to such individual pursuant to the State Medicaid Plan if the individual were not enrolled in the Health Plan’s SNP(s). (Sec. 5.11.4).