Other Full Benefit Dual Eligible. An individual who is entitled to Medicare, does not meet either QMB Plus or SMB Plus categorical income criteria, but is determined eligible for full AHCCCS benefits. For an Other Full Benefit Dual Eligible Member, AHCCCS does not provide payment for either Medicare Part A or Part B premiums. For an Other Full Benefit Dual Eligible Member, AHCCCS payments of Medicare coinsurance amounts and Medicare deductibles for Medicare covered services are limited.
Appears in 5 contracts
Samples: Health Plan Agreement, Ahcccs Agreement, Health Plan Agreement
Other Full Benefit Dual Eligible. An individual who is entitled to Medicare, does not meet either QMB Plus QMB+ or SMB Plus SMB+ categorical income criteria, but is determined eligible for full AHCCCS benefits. For an Other Full Benefit Dual Eligible Member, AHCCCS does not provide payment for either Medicare Part A or Part B premiums. For an Other Full Benefit Dual Eligible Member, AHCCCS payments of Medicare coinsurance amounts and Medicare deductibles for Medicare covered services are limited.
Appears in 3 contracts
Samples: Advantage Organization Agreement, Health Plan Agreement, Ahcccs Agreement
