Medicare Managed Care Manual (Pub. 100-16), Ch. 17f § 20.6
Authorization and Cost-Sharing
20.6 - Authorization and Cost-Sharing
(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)
Medicare cost plans:
•
Must permit in-network direct access to influenza vaccines;
•
May not impose cost sharing for influenza vaccines; and
•
Must permit in-network direct access to screening mammographies.
•
Non-emergent non-urgent-care services that Medicare cost plan enrollees obtain
from non-network providers, when not referred, are covered under original
Medicare and subject to Medicare Fee-for-Service coinsurance and deductible
requirements.