Medicare Advantage Plans definition
Examples of Medicare Advantage Plans in a sentence
COVERED BENEFIT PLAN - an arrangement, contract or undertaking pursuant to which ILS Community Network or Managed Care Plan, any ILS Community Network or Managed Care Plan Affiliate or any Payer administers or arranges for the provision of Covered Services for Enrollees, including Products/Programs incorporated in this Agreement through modifications or Amendments, Medicare Advantage Plans, and Medicaid Plans.
If a Medicare eligible non-active employee, retiree, spouse, surviving spouse or dependent resides outside the service coverage area of the available Medicare Advantage Plans, the District will continue to offer the active plan that provides out-of-area coverage.
For Medicare Advantage Plans, this Appendix supersedes any inconsistent provisions that may be found elsewhere in the Agreement.
The Medicare Advantage Plans (including Medicare Advantage with Medicare Part D coverage) and standalone Medicare Prescription Drug Plans offered by Company pursuant to contracts with CMS.
The Contractor must possess the knowledge, capability, and resourcefulness to effectively provide one or more fully-insured Medicare Advantage Plan(s) in accordance with all federal, state, and any other applicable laws, regulations, policies, OGB requirements, etc.
Members in Payors Medicare Advantage Plans may not have the ChoiceCare logo and/or name displayed on their ID cards.
The marketing guidelines set forth in this Appendix do not replace the CMS marketing requirements for Medicare Advantage Plans; they supplement them.
In many Medicare Advantage Plans, you must see your primary care doctor before you see any other health care provider.
Physician further understands and agrees that VHP will adjust Physician’s payments on a pro rata basis in the event that any Federal law or regulation changes payments made to Medicare Advantage Plans, such as VHP, including but not limited to any reductions made pursuant to a sequestration order issued in accordance with the Balanced Budget and Emergency Deficit Control Act of 1985 (BBEDCA), as amended.
For a complete description of the compensation regulations, please see: Medicare Managed Care Manual, Medicare Communications and Marketing Guidelines for Medicare Advantage Plans, Medicare Advantage Prescription Drug Plans, Prescription Drug Plans, and Section 1876 Cost Plans PacificSource reserves the right to amend its compensation rates and its compensation policy, including the rules and restrictions, in order to comply with CMS requirements.