MAPD Plan definition

MAPD Plan means the CMS approved Medicare Advantage plan sponsored, issued, or administered by the MA Health Plan as defined at 42 C.F.R. § 423.4 and includes, but is not limited to, Dual-Eligible Special Needs Plans or D-SNPs as defined in the Medicare Advantage Regulations. Qualified Disabled and Working Individuals (QWDI) means an individual lost their Medicare Part A benefits due to their return to work. They are eligible to purchase Medicare Xxx A benefits, have income of 200% FPL or less and resources that do not exceed twice the limit for SSI eligibility, and are not otherwise eligible for Medicaid. Medicaid pays the Medicare Part A premiums only. Qualified Medicare Beneficiary (QMB) means an individual who is entitled to Medicare Part A, has income that does not exceed 100% of the Federal Poverty Level (FPL), and whose resources do not exceed twice the Supplemental Security Income (SSI) limit. A QMB is eligible for Medicaid payment of Medicare premiums, deductibles, coinsurance, and co-payments (except for Medicare Part D) (“QMB Medicaid Benefits”). • QMB Only – QMBs who do not qualify for any additional QMB Medicaid Benefits. • QMB Plus– QMBs who also meet the financial criteria for full Medicaid coverage. QMB Plus individuals are entitled to QMB Medicaid Benefits, plus all benefits under the State Plan for fully eligible Medicaid recipients. Qualifying Individuals (QI) means an individual is entitled to Medicare Part A, have income of at least 120% FPL, but less than 135% FPL, resources that do not exceed twice the limit for SSI eligibility, and are not otherwise eligible for Medicaid. Medicaid pays their Medicare Part B premiums only. Specified Low-Income Medicare Beneficiary (SLMB): An individual entitled to Medicare Part A, has income that exceeds 100% FPL but less than 120% FPL, and resources do not exceed twice the SSI limit and are not otherwise eligible for Medicaid. A SLMB is eligible for Medicaid payment of Medicare Part B premium only. SLMB Plus – SLMBs that are entitled to Medicare Part A, have income of greater than 100% FPL, but less than 120% FPL and resources that do not exceed twice the limits for SSI eligibility, and are also eligible for full Medicaid coverage. Such individuals are entitled to Medicaid payment of the Medicare Part B premium, as well as full State Medicaid benefits.
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MAPD Plan means an individual Medicare Advantage Plan issued by an Insurance Carrier pursuant to a contract with CMS, which does include Medicare Part D prescription drug coverage.‌
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MAPD Plan means the CMS approved Medicare Advantage plan sponsored, issued, or administered by the MA Health Plan as defined at 42 C.F.R. § 423.4 and includes, but is not limited to, Dual-Eligible Special Needs Plans or D-SNPs as defined in the Medicare Advantage Regulations. Qualified Disabled and Working Individuals (QDWI) means an individual lost their Medicare Part A benefits due to their return to work. They are eligible to purchase Medicare Pat A benefits, have income of 200% FPL or less and resources that do not exceed twice the limit for SSI eligibility, and are not otherwise eligible for Medicaid. Medicaid pays the Medicare Part A premiums only.
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Examples of MAPD Plan in a sentence

  • The MA Health Plan has entered into a contract with the Centers for Medicare and Medicaid Services (“CMS”) to provide an MAPD Plan (“MA Agreement”) under Title XVIII and XIX of the Social Security Act, including Medicare Advantage Special Needs Plan (SNPs) that arrange for the provision of Medicare services for individuals who are dually-eligible for both Medicare and Medicaid benefits.

Related to MAPD Plan

  • Plan means any employee pension benefit plan (other than a Multiemployer Plan) subject to the provisions of Title IV of ERISA or Section 412 of the Code or Section 302 of ERISA, and in respect of which the Borrower or any ERISA Affiliate is (or, if such plan were terminated, would under Section 4069 of ERISA be deemed to be) an “employer” as defined in Section 3(5) of ERISA.

  • Transition Plan means a transition plan, acceptable to the LHIN that indicates how the needs of the HSP’s clients will be met following the termination of this Agreement and how the transition of the clients to new service providers will be effected in a timely manner; and

  • Health benefit plan means a policy, contract, certificate or agreement offered or issued by a health carrier to provide, deliver, arrange for, pay for or reimburse any of the costs of health care services.