Medicare Advantage Supplemental Benefits. Services that are covered as Supplemental Benefits under Health Plan’s D-SNP(s) and overlap with Medicaid Benefits under New York’s Medicaid Plan shall be first adjudicated by Health Plan as claims for services under the Supplemental Benefit offered by Health Plan’s D-SNP(s) before treating such claims as SDOH responsibility under the State Medicaid Plan.
Medicare Advantage Supplemental Benefits. The Agency acknowledges that (i) the Health Plan's plan benefit design, including the benefits and cost-sharing obligations, provided under such design may vary from plan-to-plan and from year-to-year; (ii) in any given benefit year, the plan benefit packages offered by the Health Plan's SNP may include certain Medicare Supplemental Benefits that may overlap with Medicaid benefits covered by the Medicaid State Plan; and (iii) for services that are covered as Supplemental Benefits under the Health Plan's SNP(s) as well as benefits under the Medicaid State Plan, the Health Plan shall first adjudicate claims for in-network services under the Supplemental Benefit offered by the Health Plan's SNP(s) before denying such claims as Agency responsibility under the Medicaid State Plan. The Health Plan shall ensure that claims are processed and comply with the federal and state requirements set forth in 42 CFR 447.45 and 447.46 and Chapter 641, F.S. AGREEMENT NO. SNP001
