Medicare Managed Care Manual (Pub. 100-16), Ch. 17f § 10.7
Cost-Sharing and Deductibles
10.7 - Cost-Sharing and Deductibles
(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)
(42 CFR 417.452(a)(3)) The sum of the amounts the Medicare cost plan charges its
Medicare enrollees for Medicare deductibles and coinsurance may not exceed, on the
average, the actuarial value of the deductible and coinsurance the Medicare enrollees
otherwise would have been liable for had they not enrolled in the Medicare cost plan.