Dual eligible special needs plan definition

Dual eligible special needs plan means a special needs plan that enrolls beneficiaries entitled to both Medicare and Medicaid.
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Dual eligible special needs plan. (Dual Eligible SNP)” means the Medicare Part C and other health plan services provided to MA Health Plan Members under a SNP as defined and pursuant to an MA Agreement, as defined in 42 C.F.R. § 422.2.
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Dual eligible special needs plan means a special needs plan that enrolls beneficiaries
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Examples of Dual eligible special needs plan in a sentence

  • Integrated Models on a ContinuumLow level of integration• Dual eligible special needs plan (D-SNP).


More Definitions of Dual eligible special needs plan

Dual eligible special needs plan or “FIDE SNP” means a D-SNP (1) that provides Dual-Eligible Beneficiaries access to Medicare and Medicaid benefits under a single entity that holds both a Medicare Advantage contract with CMS and a Medicaid managed care organization contract under section 1903(m) of the Social Security Act with SDOH; (2) whose capitated contract with SDOH provides coverage, consistent with SDOH policy, of specified primary care, acute care, behavioral health, and long-term services and supports, and provides coverage of nursing facility services for a period of at least 180 days during the plan year; (3) that coordinates the delivery of covered Medicare and Medicaid services using aligned care management and specialty care network methods for high-risk beneficiaries; and (4) that employs policies and procedures approved by CMS and SDOH to coordinate or integrate beneficiary communication materials, enrollment, communications, grievance and appeals, and quality improvement; and (5) has received CMS designation as a FIDE SNP.
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Dual eligible special needs plan or “D-SNP” means a type of health benefits plan offered by a Centers for Medicare and
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Related to Dual eligible special needs plan

  • Qualifying Educational Program means a program at a post-secondary school level of not less than three consecutive weeks duration that requires each student taking the program to spend not less than 10 hours per week on courses or work in that program.

  • Special needs child means a person under the age of 18 at the time of adoption, who is a dependent of a public or private non-profit adoption agency, is legally free for adoption and has been determined by the agency to have specific conditions.

  • Child with special needs means a child with one or more of the following conditions:

  • Statewide special election means a special election called by the governor or the

  • Dual status military technician means a federal civilian employee who is:

  • Number of Students Who Began Program means the number of students who began the program who are scheduled to complete the program within the reporting calendar year.

  • Approved abuse education training program means a training program using a curriculum approved by the abuse education review panel of the department of public health or a training program offered by a hospital, a professional organization for physicians, or the department of human services, the department of education, an area education agency, a school district, the Iowa law enforcement academy, an Iowa college or university, or a similar state agency.

  • Eligible Ground Lease means a ground lease containing terms and conditions customarily required by mortgagees making a loan secured by the interest of the holder of the leasehold estate demised pursuant to a ground lease, and shall include the following: (a) a remaining term (exclusive of any unexercised extension options) of 30 years or more from the date the applicable Property first becomes an Eligible Property; (b) the right of the lessee to mortgage and encumber its interest in the leased property without the consent of the lessor; (c) the obligation of the lessor to give the holder of any mortgage Lien on such leased property written notice of any defaults on the part of the lessee and agreement of such lessor that such lease will not be terminated until such holder has had a reasonable opportunity to cure or complete foreclosures, and fails to do so; (d) reasonable transferability of the lessee’s interest under such lease, including ability to sublease; and (e) clearly determinable rental payment terms which in no event contain profit participation rights.

  • Special Needs beneficiary is one who needs additional time to complete his/ her education due to physical, mental or emotional limitations. In addition, as discussed below, a beneficiary may roll over contributions to another Xxxxxxxxx Education Savings Account until he or she attains age 30. A beneficiary may also roll over his or her Xxxxxxxxx Education Savings Account to a new beneficiary who is a member of his or her family so long as the recipient has not attained age 30.

  • Medical flexible spending arrangement means a benefit plan

  • Group health plan means an employee welfare benefit plan as defined in section 3(1) of subtitle A of title I of the employee retirement income security act of 1974, Public Law 93-406, 29 USC 1002, to the extent that the plan provides medical care, including items and services paid for as medical care to employees or their dependents as defined under the terms of the plan directly or through insurance, reimbursement, or otherwise.

  • Basic health plan means the plan described under chapter

  • Basic health plan model plan means a health plan as required in RCW 70.47.060(2)(e).

  • Qualified Ground Lease means each of the ground leases or ground subleases set forth on Schedule 1.01(d) hereto and for a Future Property means any ground lease (a) which is a direct ground lease or ground sublease granted by the fee owner of real property or a master ground lessee from such fee owner, (b) which may be transferred and/or assigned without the consent of the lessor (or as to which the lease expressly provides that (i) such lease may be transferred and/or assigned with the consent of the lessor and (ii) such consent shall not be unreasonably withheld or delayed) or subject to certain reasonable pre‑defined requirements, (c) which has a remaining term (including any renewal terms exercisable at the sole option of the lessee) of at least twenty (20) years, (d) under which no material default has occurred and is continuing, (e) with respect to which a Lien may be granted without the consent of the lessor (but subject to customary requirements regarding the nature of the holder of such Lien and prior notice to the lessor), (f) which contains customary and reasonable lender protection provisions, including, without limitation, provisions to the effect that (i) the lessor shall notify any holder of a Lien in such lease of the occurrence of any default by the lessee under such lease and shall afford such holder the option to cure such default, and (ii) in the event that such lease is terminated, such holder shall have the option to enter into a new lease having terms substantially identical to those contained in the terminated lease and (g) which otherwise contains no non-customary terms that are material and adverse to the lessee.

  • Master Plan means a subcontracting plan that contains all the required elements of an individual contract plan, except goals, and may be incorporated into individual contract plans, provided the master plan has been approved.

  • Cooperative education program means a written voluntary agreement between and among districts to provide certain educational programs for pupils in certain groups of districts. The written agreement shall be approved by all affected districts at least annually and shall specify the educational programs to be provided and the estimated number of pupils from each district who will participate in the educational programs.

  • Non-Participating Certified Clinical Nurse Specialist means a Certified Clinical Nurse Specialist who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Optional Extended Local Calling Scope Arrangement Traffic is traffic that under an optional Extended Local Calling Scope Arrangement chosen by the Customer terminates outside of the Customer’s basic exchange serving area.

  • Eligible pupil means a pupil who has been expelled from school under the mandatory expulsion provisions in section 1311 or 1311a of the revised school code, MCL 380.1311 and 380.1311a, a pupil who has been suspended or expelled from school under a local policy, a pupil who is referred by a court, a pupil who is pregnant or is a parent, a pupil who was previously a dropout, or a pupil who is determined by the district to be at risk of dropping out.

  • aerodrome control service means air traffic control service for aerodrome traffic;

  • Dental hygienist means an individual who has fulfilled the educational requirements and is a graduate of an accredited dental hygiene program and who has passed an examination and has been issued a license by the Board and who is authorized to practice dental hygiene as hereinafter defined;

  • Qualifying student means a student who is a South Carolina resident and who is eligible to be enrolled in a South Carolina secondary or elementary public school at the kindergarten or later year level for the current school year.

  • Independent educational evaluation means an evaluation conducted by a qualified examiner who is not employed by the public agency responsible for the education of the child in question.

  • Eligible list means an official record kept in the Commissioner's office as a public record which contains the names of those persons who have successfully completed examinations, listed and ranked in order of their final ratings from the highest to the lowest rank.

  • Qualified health plan means a health benefit plan that has in effect a certification that the plan

  • Qualifying exigency means a situation where the eligible employee seeks leave for one or more of the following reasons: