Voluntary Populations. In order to be eligible for the frail/elderly program, enrollees must be: a. Assessed by CARES as having met a nursing home level of care and in need of services to live in their homes or in the homes of relatives or caregivers, as an alternative to being placed in a nursing home facility; b. Twenty-one (21) years of age or older; c. An SSI beneficiary including dually-eligible Individuals with Medicare coverage (dual eligible with either Medicare Part B coverage or Medicare Parts A and B coverage) who are not enrolled in a Medicare Advantage Plan or a Medicare Advantage Special Needs Plan and not otherwise ineligible under the terms of this Contract; and d. Not ineligible as listed in Section III, Eligibility and Enrollment, Item A.3. below.
Appears in 4 contracts
Samples: Standard Contract (Amerigroup Corp), Health Plan Contract, Health Plan Contract