Medicare Advantage Prescription Drug Plan definition

Medicare Advantage Prescription Drug Plan means a Medicare Advantage Prescription Drug Plan as defined by Law.
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Medicare Advantage Prescription Drug Plan or “MA-PD” means a Medicare Advantage plan that is certified by Centers for Medicare and Medicaid Services (CMS) as meeting contract requirements as specified in 42 C. F. R. § 422.2 that provides qualified prescription drug coverage under Part D of the Social Security Act.
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Medicare Advantage Prescription Drug Plan means an entity authorized by the Centers for Medicare and Medicaid Services to provide prescription drug coverage to Medicare Advantage beneficiaries.
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Examples of Medicare Advantage Prescription Drug Plan in a sentence

  • This application must be used for all organizations seeking new Prescription Drug Plan (PDP) and Medicare Advantage- Prescription Drug Plan (MA-PD) contracts, seeking to expand the service area of existing contracts, and seeking to add prescription drug coverage.

  • CountyCare intends to submit applications to the Centers for Medicare & Medicaid Services (CMS) to operate several different Medicare Advantage plans, including a general Medicare Advantage Prescription Drug Plan (MAPD) and potentially Chronic Condition Special Needs Plan (C-SNP), Institutional Special Needs Plan (I-SNP) and Dual Eligible Special Needs Plan (D-SNP), effective January 1, 2020.

  • A Medicare Advantage Prescription Drug Plan (MA-PD) provides all Medicare benefits in one plan, including prescription drugs.

  • The 2022 Solicitation for Applications for New Medicare Advantage Prescription Drug Plan (MA- PD) Sponsors must also be submitted electronically through HPMS.

  • Active employees and non-Medicare eligible retirees who do not have Medicare eligible dependents can enroll in a Medicare Advantage Prescription Drug Plan (MAPDP) in lieu of the basic hospital medical plan.

  • Enrollees who otherwise are included in Medicare reassignment effective January 1 of a given year either from their current Medicare Prescription Drug Plan (PDP) or terminating Medicare Advantage Prescription Drug Plan (MA-PD) to another PDP, will not be eligible for Passive Enrollment that same year.

  • Individuals who otherwise would be eligible for Medicare reassignment in 2013 or 2014 from their current (2012 or 2013, respectively) Medicare Prescriptions Drug Plan (PDP) or terminating Medicare Advantage Prescription Drug Plan (MA-PD) to another PDP, will be eligible for passive enrollment, with an opportunity to opt-out, into a Demonstration Plan effective January 1, 2014.

  • Together these documents will comprise a completed application for new MAOs. Failure to complete, if applicable, the2022 Solicitation for Applications for New Medicare Advantage Prescription Drug Plan (MA-PD) Sponsors, may result in a denial of the EGWP application.

  • A Medicare Advantage Prescription Drug Plan requires enrollment in Parts A and B of Medicare and covers all the same benefits as Medicare Parts A and B, Medicare Part D (prescription drug) benefits, and sometimes includes additional benefits.

  • Medicare Advantage Prescription Drug Plan (MA-PD): An MA plan that provides qualified prescription drug coverage.

Related to Medicare Advantage Prescription Drug Plan

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Prescription drug means any drug required by federal law or regulation to be dispensed only

  • Nonprescription drug or "over-the-counter drug" means any

  • Prescription drugs means drugs, medicine and controlled substances which by law can only be prescribed for human use by persons authorized by law.

  • Nonprescription drugs means nonnarcotic medicines or drugs which may be sold without a prescription and are prepackaged and labeled for use by the consumer in accordance with the requirements of the statutes and regulations of this state and the federal government;

  • Prescription drug order means an order from a prescriber for a drug or device that is

  • MEDICAL PRESCRIPTION DRUGS are prescription drugs that require administration (or the FDA approved recommendation is for administration) by a licensed healthcare provider (other than a pharmacist). These medical prescription drugs include, but are not limited to, medications administered by infusion, injection, or inhalation, as well as nasal, topical or transdermal administered medications. Medical prescription drugs are covered as a medical benefit. MEDICALLY NECESSARY (MEDICAL NECESSITY) means that the healthcare services provided to treat your illness or injury, upon review by BCBSRI are: • appropriate and effective for the diagnosis, treatment, or care of the condition, disease, ailment or injury for which it is prescribed or performed; • appropriate with regard to generally accepted standards of medical practice within the medical community or scientific evidence; • not primarily for the convenience of the member, the member’s family or provider of such member; and • the most appropriate in terms of type, amount, frequency, setting, duration, supplies or level of service, which can safely be provided to the member (i.e. no less expensive professionally acceptable alternative, is available). We will make a determination whether a healthcare service is medically necessary. You have the right to appeal our determination or to take legal action as described in Section

  • Participating Prescription Drug Provider means an independent retail Pharmacy, chain of retail Pharmacies, mail-order Pharmacy or specialty drug Pharmacy which has entered into an agreement to provide pharmaceutical services to participants in the benefit program. A retail Participating Pharmacy may or may not be a select Participating Pharmacy as that term is used in the Vaccinations Obtained Through Participating Pharmacies section.

  • Managed care plan means a health benefit plan that either requires a covered person to use, or

  • Managed Care Plans means all health maintenance organizations, preferred provider organizations, individual practice associations, competitive medical plans and similar arrangements.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

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

  • Medicaid program means the Kansas program of medical

  • Managed Care Program means the process that determines Medical Necessity and directs care to the most appropriate setting to provide quality care in a cost-effective manner, including Prior Authorization of certain services.

  • Prescription means an order for drugs or medical supplies, written or signed or transmitted by word

  • Licensed health care practitioner means a physician, as defined in Section 1861(r)(1) of the Social Security Act, a registered professional nurse, licensed social worker or other individual who meets requirements prescribed by the Secretary of the Treasury.

  • Drug abuse means any pattern of pathological use of drugs that causes impairment in social or occupational functioning, or that produces physiological dependency evidenced by physical tolerance or by physical symptoms when it is withdrawn.

  • Basic health plan means the plan described under chapter

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Medical Reimbursement Programs means a collective reference to the Medicare, Medicaid and TRICARE programs and any other health care program operated by or financed in whole or in part by any foreign or domestic federal, state or local government and any other non-government funded third party payor programs.

  • HCFA means the Health Care Financing Administration.

  • Federal Health Care Program means any “federal health care program” as defined in 42 U.S.C. § 1320a-7b(f), including Medicare, state Medicaid programs, state CHIP programs, TRICARE and similar or successor programs with or for the benefit of any Governmental Authority.

  • Dependent care assistance program or "DCAP" means a benefit plan whereby school employees may pay for certain employment related dependent care with pretax dollars as provided in the salary reduction plan under chapter 41.05 RCW pursuant to 26 U.S.C. Sec. 129 or other sections of the Internal Revenue Code.

  • 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.

  • Medicare benefit means the Medicare benefit payable within the meaning of Part II of the Health Insurance Act 1973 with respect to a professional service.

  • National Flood Insurance Program means the program created by the U.S. Congress pursuant to the National Flood Insurance Act of 1968 and the Flood Disaster Protection Act of 1973, as revised by the National Flood Insurance Reform Act of 1994, that mandates the purchase of flood insurance to cover real property improvements located in Special Flood Hazard Areas in participating communities and provides protection to property owners through a Federal insurance program.