Common use of Enrollee Choice Clause in Contracts

Enrollee Choice. (A) The Department or the Department’s designee shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all Integrated Care Plans available in the Service Area. (B) The Department will inform Potential Enrollees of Medicaid benefits. (C) The Medicaid Eligible Individual’s intent to enroll is established when the applicant selects the Contractor, either verbally or by signing a choice of health care delivery form or equivalent. If the Enrollee does not choose an Integrated Care Plan, the Department shall automatically assign the Enrollee to an Integrated Care Plan based on a methodology approved by CMS. This initiates the action to send an advance notification to the Contractor. (D) Enrollees made eligible for a retroactive period prior to the current month are not eligible for Contractor enrollment during the retroactive period.

Enrollee Choice. (A) The Department or the Department’s designee shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all Integrated Care Plans available in the Service Area. (B) The Department will shall inform Potential Enrollees of Medicaid benefits. (C) The Medicaid Eligible Individual’s intent to enroll is established when the applicant selects the Contractor, either verbally or by signing a choice of health care delivery form or equivalent. If the Enrollee does not choose an Integrated Care Plan, the Department shall automatically assign the Enrollee to an Integrated Care Plan based on a methodology approved by CMS. This initiates the action to send an advance notification to the Contractor. (D) Enrollees made eligible for a retroactive period prior to the current month are not eligible for Contractor enrollment during the retroactive period.