Medicare Product definition

Medicare Product means any of the following:
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Medicare Product means one or more health benefits programs offered by Company to Groups or Individuals. The Medicare Product or Medicare Products applicable to this Agree- ment are set forth in the commission sched- ules attached as Exhibit C (“Commission Schedules”). References in this Agreement to CMS are limited to those Medicare Products that Company offers pursuant to one or more contracts with CMS.
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Medicare Product is any Medicare Advantage Plan, Medicare Advantage Prescription Drug Plan, or stand- alone Prescription Drug Plan that may now or in the future be offered to individual Medicare beneficiaries by BCBST. Medicare Product does not include any Medicare supplement insurance products offered by BCBST.
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Examples of Medicare Product in a sentence

  • Additionally, this Agreement shall be amended to exclude any Medicare Product or State-licensed entity specified by CMS.

  • In the event that Sponsor, pursuant to a separate agreement, delegates to Participating Provider certain Sponsor obligations under its agreement with CMS to provide a Medicare Product, Participating Provider shall perform such obligations as set forth in that agreement and in accordance with all applicable laws, regulations and government policies and pronouncements.

  • Participating Provider acknowledges that payments for Covered Services rendered to Members enrolled in a Medicare Product are, in whole or in part, derived from federal funds and receipt of such payment is subject to all laws and regulations applicable to recipients of such funds.

  • This Medicare Product Attachment shall terminate upon the termination of the Agreement and under the same terms and conditions specified in the Agreement.

  • Nothing in this Medicare Product Attachment shall be held to vary, alter, waive or extend any of the terms, conditions, agreements or limitations of the Agreement, including the Provider Manual, except as stated in this Medicare Product Attachment.

  • Upline and Agent are prohibited from obtaining any applications from prospective or current Medicare Product Enrollees for an open enrollment period prior to the first day of open enrollment, October 15th (or such other date established by CMS).

  • The Medicare Product includes those Coverage Agreements entered into, issued or agreed to by a Payor under which a Company furnishes administrative services or other services in support of a Medicare Product.

  • In addition to the limitations set forth in Section B(3) of Schedule D-1to Appendix D, Upline shall not institute legal proceedings against any applicant or enrollee of any Medicare Product for any cause arising out of the business transacted under this Agreement unless Aetna shall have been notified in writing of such action or the proposed action prior to or simultaneously with the institution of such legal proceedings.

  • Upline and its Agents are prohibited from charging any insured or applicant for a Medicare Product any fee or charge whatsoever.

  • If the Replacement has an effective date other than January 1st, a pro-rated amount of the “Replacement Rate” set forth on Schedule 1 will be paid, based upon the number of months the Medicare Product Enrollee will be enrolled in such Medicare Product within the initial calendar year.


More Definitions of Medicare Product

Medicare Product refers to those programs and health benefit arrangements offered by Health Plan or another Company in connection with one or more of the following Medicare product types that is administered, sponsored or regulated by the federal government (or any agency, department or division thereof) on its own or jointly with a State that administers or regulates such program or plan (each a “Medicare Product Type”): a non-Dual Eligible Special Needs Plan Medicare Advantage plan (“MA Plan”); a Medicare Advantage prescription drug plan (“MA-PD Plan”); a Dual Eligible Special Needs Plan (“DSNP Plan”); a Capitated Financial Alignment Demonstration (“MMP Plan”) plan or program (e.g., a plan or program adopted or established under the Affordable Care Act of 2010, to test new service delivery and payment models for people dually eligible for Medicare and Medicaid, including any regulations or CMS pronouncements and any future Attachments); or other Medicare Product Types. The Medicare Product includes those Coverage Agreements entered into, issued or agreed to by a Payor under which a Company furnishes administrative services or other services in support of a Medicare Product. The Medicare Product does not apply to any Coverage Agreements that are specifically covered by another Product Attachment to the Agreement. This Attachment applies only to the provision of health care services, supplies or accommodations (including Covered Services) to Covered Persons enrolled in the Medicare Product. Provider acknowledges that it will participate in each Medicare Product Type for which a Compensation Schedule(s) is attached to this Medicare Product Attachment.
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Medicare Product means the forms of medicare coverage under which medicare beneficiaries may obtain coverage from a risk- bearing entity, including a medicare advantage plan;
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Medicare Product means any of the following: a “prescription drug plan”, as such term is defined under Medicare Part D at 42 USC § 1395w-151(a)(14) (“Medicare Prescription Drug Plan”; a “Medicare supplemental policy”, as such term is defined under Medicare Part E at 42 USC § 1395ss(g)(1) (“Medicare Supplement Policy”); the health benefits coverage provided under Medicare Part C at 42 USC §§ 1395w-21 et seq. (“Medicare Advantage Plan”); or a Medicare Advantage Plan that provides qualified prescription drug coverage, as described under Medicare Part D at 42 USC § 1395w-101(a)(3)(C) (“Medicare Advantage‐ Prescription Drug Plan”).
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Related to Medicare Product

  • 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.

  • 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.

  • FDA means the United States Food and Drug Administration.

  • Tobacco product means any substance containing tobacco leaf, including but not limited to, cigarettes, cigars, pipe tobacco, hookah tobacco, snuff, chewing tobacco, dipping tobacco, bidis, blunts, clove cigarettes, or any other preparation of tobacco; and any product or formulation of matter containing biologically active amounts of nicotine that is manufactured, sold, offered for sale, or otherwise distributed with the expectation that the product or matter will be introduced into the human body by inhalation; but does not include any cessation product specifically approved by the U.S. Food and Drug Administration for use in treating nicotine or tobacco dependence.

  • Health care practitioner means an individual licensed

  • Pharmacy means prescribed drugs and medicines dispensed by a pharmacist and/or travel and allergy vaccines dispensed by a pharmacist or doctor.

  • Product means any deliverable under the Contract, which may include commodities, services, technology or software.

  • Medicaid means that government-sponsored entitlement program under Title XIX, P.L. 89-97 of the Social Security Act, which provides federal grants to states for medical assistance based on specific eligibility criteria, as set forth on Section 1396, et seq. of Title 42 of the United States Code.