Member or Enrollee definition

Member or Enrollee means a person who: is entitled to benefits under Title XIX of the Social Security Act and the Texas Medical Assistance Program (Medicaid), is in a Medicaid eligibility category included in the STAR Program, and is enrolled in the STAR Program.
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Member or Enrollee. A Medicare Advantage eligible individual who has enrolled in or elected coverage through a Medicare Advantage Organization.
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Member or Enrollee shall have the meaning set forth in Exhibit D, Schedule 1 of this Exhibit D.
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Examples of Member or Enrollee in a sentence

  • Member or Enrollee: a Medicare Advantage eligible individual who has enrolled in or elected coverage through a Medicare Advantage Organization.

  • Member or Enrollee: a Medicare Advantage eligible individual who has enrolled in or elected coverage through a MAO.


More Definitions of Member or Enrollee

Member or Enrollee means a Medicaid-eligible person receiving benefits through a RIte Care managed care organization.
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Member or Enrollee means a Potential Member who has enrolled with Contractor.
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Member or Enrollee. - means any person enrolled in the prepaid program of the HMO who has selected the IPA as his/her provider of Medical Services.
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Related to Member or Enrollee

  • Enrollee means any person entitled to health care services from a carrier.

  • Non-Participating Certified Nurse Practitioner means a Certified Nurse Practitioner who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Participating Certified Nurse Practitioner means a Certified Nurse Practitioner who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • child care element of working tax credit means the element of working tax credit prescribed under section 12 of the Tax Credits Act 2002 (child care element).

  • Non-Participating Clinical Professional Counselor means a Clinical Professional Counselor who does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Health care practitioner means an individual licensed

  • Genetic counselor means a person licensed by the Board to engage in the practice of genetic

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Managed care entity means an insurer that:

  • Community health worker means an individual who:

  • Participating Clinical Professional Counselor means a Clinical Professional Counselor who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Licensed health care professional means a person who possesses a professional medical license that is valid in Oregon. Examples include, but are not limited to, a registered nurse (RN), nurse practitioner (NP), licensed practical nurse (LPN), medical doctor (MD), osteopathic physician (DO), respiratory therapist (RT), physical therapist (PT), physician assistant (PA), or occupational therapist (OT).

  • Nurse practitioner means an advanced practice registered nurse who is jointly licensed by the