Expanded Benefit Clause Samples
Expanded Benefit. A benefit offered to all enrollees covered by the Managed Care Plan for which the plan receives no direct payment from the Agency.
Expanded Benefit. A benefit offered to all enrollees in specific population groups, covered by the Managed Care Plan for which the Managed Care Plan receives no direct payment from the Agency. These specific population groups are as follows: TANF; SSI No Medicare, non-LTC eligible; SSI with Medicare, non-LTC eligible; Dual Eligible, LTC eligible; Medicaid Only, LTC eligible; HIV/AIDS Specialty Population, with Medicare; HIV/AIDS Specialty Population, No Medicare; and Child Welfare Specialty Population.
Expanded Benefit. Adult Dental Adult dental expanded to include unlimited fillings, periodontic deep cleanings, crowns, clear fillings, restorations, annual exam, two cleanings per year, and x-rays. Circumcision Routine newborn circumcision up to one year of age. Over the Counter Benefit Agency approved over-the-counter drug benefit, not to exceed $25 per household, per month. Limited to non-prescription drugs containing a National Drug Code number, first aid and birth control supplies. Benefit must be offered through a plan’s pharmacy or plan’s subcontractor. Meals on Wheels 10 meals within 15 days of post discharge (medically necessary)