Fully Dual Eligible definition

Fully Dual Eligible means for the purposes of Medicare Part D coverage (42 CFR 423.772), Medicare clients who are also eligible for Medicaid, meeting the income and other eligibility criteria adopted by the Authority for full medical assistance coverage.
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Fully Dual Eligible and “Full Benefit Dual Eligible” and “FBDE” each has the meaning provided for in OAR 410-120-0000.
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Fully Dual Eligible and “Full Benefit Dual Eligible” and “FBDE” each has the meaning provided for in OAR 410-120-0000. not less than thirty-six (4036) hours in any one calendar week.
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Examples of Fully Dual Eligible in a sentence

  • Prescription drugs and drug classes covered by Medicare Part D for Fully Dual Eligible Members are not a Covered Service.

  • To effectively integrate and coordinate health care and care management for Fully Dual Eligible Members, Contractor shall demonstrate its ability to provide Medicare benefits to Fully Dual Eligible Members.

  • Integrated materials to be updated (iii) within the time period required by Medicare if the Contractor is providing an Integrated Medicare-Medicaid Member Handbook for the FBDE Enrolled Member is a Fully Dual Eligible Member with their affiliated or contracted MA or DSNP.

  • In order to be included in Contractor’s Provider Directory, Contractor’s Providers, whether under contract directly with, or Subcontracted by, Contractor, must have agreed to provide the Covered Services or items to its Medicaid and Fully Dual Eligible Members.

  • For those Contractors affiliated with or contracted with an entity that provides services as a Medicare Advantage plan serving Fully Dual Eligibles, Contractor shall demonstrate on a yearly basis that its Provider Network is adequate to provide both the Medicare and the Medicaid Covered Services to its Fully Dual Eligible population.

  • Contractor shall pay for Covered Services for Members who are Fully Dual Eligible in accordance with applicable contractual requirements that include CMS and OHA.

  • Contractors that are affiliated with or contracted with an entity that provides services as a Medicare Advantage plan serving Fully Dual Eligible Members for Medicare and Medicaid may not impose cost-sharing requirements on Fully Dual Eligible Members and QMB that would exceed the amounts permitted by OHP if the Member is not enrolled in the Contractor’s Medicare Advantage plan.

  • Contractor shall furnish to each of its Members a Member handbook that contains all of the information specified in Exhibit J, consistent with the requirements of 42 CFR 438.10(h), if applicable, within a reasonable time after the Contractor received notice of the recipient’s Enrollment from OHA or for clients who are Fully Dual Eligible, within the time period required by Medicare.

  • Any director may resign effective on giving written notice to the chairman of the board, the president/chief executive officer, the secretary or the board of directors, unless the notice specifies a later time for that resignation to become effective.

  • Contractor must both mail and otherwise make its OHA approved Member Handbooks within: (i) fourteen (14) days of receiving OHA’s initial 834 listing of Member’s Enrollment (or re-Enrollment after not being Enrolled for ninety (90) days or more) with the Contractor, (ii) within fourteen (14) days of any other receipt of notice of a Member’s Enrollment, and (iii) within the time period required by Medicare if the Enrolled Member is a Fully Dual Eligible Member.

Related to Fully Dual Eligible

  • Retirement Eligible means that the Participant has either attained age 55 and completed ten (10) years of Service as an Employee or attained age 60 and completed five (5) years of Service as an Employee.

  • DWAC Eligible means that (a) the Common Stock is eligible at DTC for full services pursuant to DTC’s Operational Arrangements, including, without limitation, transfer through DTC’s DWAC system, (b) the Company has been approved (without revocation) by the DTC’s underwriting department, (c) the Transfer Agent is approved as an agent in the DTC/FAST Program, (d) the Conversion Shares are otherwise eligible for delivery via DWAC, and (e) the Transfer Agent does not have a policy prohibiting or limiting delivery of the Conversion Shares via DWAC.

  • Eligible child means the children of:

  • Eligible veteran means an individual who is certified by the Wisconsin Department of Veterans Affairs as meeting all of the following conditions:

  • Eligible Children means named dependent children including adopted and step children of the Insured Person between Ages three (3) years and eighteen (18) years or upto twenty three (23) years if attending as a full time student with an accredited Institution of Higher Learning, who are unmarried, and receive the majority of maintenance and support from the Insured Person.

  • Eligible group means two or more persons who are engaged in a

  • Adjusted Covered Debt Balance means, on any date, the aggregate Covered Debt Amount on such date minus the aggregate amount of Cash and Cash Equivalents included in the Portfolio Investments held by the Obligors (provided that Cash Collateral for outstanding Letters of Credit shall not be treated as a portion of the Portfolio Investments).

  • S&P Eligible Asset means: (1) cash (excluding any cash irrevocably deposited by the Fund for the payment of any liabilities within the meaning of MTP Basic Maintenance Amount), (2) Receivables for Municipal Obligations Sold, (3) S&P Hedging Transactions or (4) a Municipal Obligation (including Inverse Floater as defined below) owned by the Fund that (A) is interest bearing and pays interest at least semi-annually; (B) is payable with respect to principal and interest in U.S. Dollars; (C) is not subject to a covered call or put option written by the Fund; (D) except for Inverse Floaters, is not part of a private placement of Municipal Obligations; and (E) except for Inverse Floaters, is part of an issue of Municipal Obligations with an original issue size of at least $10 million. Any Municipal Obligation that is a part of an original issue size of less than $10 million must carry a rating of at least “AA” by S&P or “AAA” by Moody’s, Fitch or another nationally recognized statistical rating organization. Notwithstanding the foregoing limitations:

  • Eligible means that the individual obtained the checks and clearances described in sections 5n and 5q and is considered appropriate to obtain a license, to be a member of the household of a group child care home or family child care home, or to be a child care staff member.

  • Retirement Eligibility means Employee’s attainment of 60 years of age and ten years of continuous employment with Corporation.

  • (1) ELIGIBLE ENTITY.—The term eligible entity’ means—

  • DTC Eligible means, with respect to the Common Stock, that such Common Stock is eligible to be deposited in certificate form at the DTC, cleared and converted into electronic shares by the DTC and held in the name of the clearing firm servicing Lender’s brokerage firm for the benefit of Lender.

  • Eligible Foreign Accounts means Accounts with respect to which the account debtor does not have its principal place of business in the United States and that (i) are supported by one or more letters of credit in an amount and of a tenor, and issued by a financial institution, acceptable to Bank, or (ii) that Bank approves on a case-by-case basis.

  • Eligible Earnings means the Grantee's base salary (prior to any deferrals under a cash or deferred compensation plan sponsored by the Corporation or an Affiliate) paid during the Plan Year. From time to time the Plan Administrator may, in its sole discretion, establish rules for determining the amounts of Eligible Earnings for employees who become Grantees other than on the first day of a Plan Year as well as any reduction of Eligible Earnings as a result of paid leave of absences.

  • Eligible Unit means, as of the time any Liquidating Gain is available to be allocated to an LTIP Unit or a Performance Unit, an LTIP Unit or Performance Unit to the extent, since the date of issuance of such LTIP Unit or Performance Unit, such Liquidating Gain when aggregated with other Liquidating Gains realized since the date of issuance of such LTIP Unit or Performance Unit exceeds Liquidating Losses realized since the date of issuance of such LTIP Unit or Performance Unit, as applicable.

  • Fully Satisfied means, with respect to the Obligations as of any date, that, as of such date, (a) all principal of and interest accrued to such date which constitute Obligations shall have been irrevocably paid in full in cash, and (b) all fees, expenses and other amounts then due and payable which constitute Obligations shall have been irrevocably paid in cash.

  • Individual retirement account means a trust, custodial arrangement, or annuity under Section 408(a) or (b), Internal Revenue Code of 1954 (26 U.S.C. Section 408 (1986)).

  • Foreign Account means an Account in which Foreign Currencies or Securities are held by the Custodian for the benefit of clients whether in comingled accounts or accounts designated for each beneficial owner as is required under the regulatory jurisdiction where the Foreign Account is established.

  • Qualified veteran means a person who meets the following requirements:

  • Medicare eligible expenses means expenses of the kinds covered by Medicare Parts A and B, to the extent recognized as reasonable and medically necessary by Medicare.

  • Control Eligible Certificates Any of the Class E, Class F and Class G Certificates.

  • Eligible Unbilled Receivable means, at any time, any Unbilled Receivable if (a) the related Originator has recognized the related revenue on its financial books and records under GAAP, and (b) not more than thirty (30) days have expired since the date such Unbilled Receivable arose.

  • Shares Eligible for Future Sale and "Underwriters" and (B) in the Registration Statement in Items 14 and 15, in each case insofar as such statements constitute summaries of the legal matters, documents or proceedings referred to therein, fairly present the information called for with respect to such legal matters, documents and proceedings and fairly summarize the matters referred to therein;

  • 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.

  • frozen account means an account with a relevant institution which is held or controlled (directly or indirectly) by a designated person;

  • Domestic Reserve Percentage means for any day that percentage (expressed as a decimal) which is in effect on such day, as prescribed by the Board of Governors of the Federal Reserve System (or any successor) for determining the maximum reserve requirement (including without limitation any basic, supplemental or emergency reserves) for a member bank of the Federal Reserve System in New York City with deposits exceeding five billion dollars in respect of new non-personal time deposits in dollars in New York City having a maturity comparable to the related Interest Period and in an amount of $100,000 or more. The Adjusted CD Rate shall be adjusted automatically on and as of the effective date of any change in the Domestic Reserve Percentage.