Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 10.5.1

Uniformity

Last amended: 2016Year: 2016Length: 209 wordsOfficial source
10.5.1 – Uniformity (Rev. 121, Issued: 04-22-16, Effective: 04-22-16, Implementation: 04-22-16) The following rules apply to any MA plan, regardless of plan type, and to any category of benefit – basic, mandatory supplemental, and optional supplemental. • All plan benefits must be offered uniformly to all enrollees residing in the service area of the plan; • When an MA plan has an authorized service area with one or more approved segments, as defined in 42 CFR §422.2, the MA plan may vary premiums and cost- sharing by segment, but the premium and cost-sharing must be uniform within each segment. Furthermore, plan benefits must be uniformly provided throughout the authorized service area of the plan, including any segments in the service area; • The uniform premium requirement prohibits plans from offering nominal discounts to those enrollees electing to pay premiums electronically; • All plans must offer to, but may not require of, their enrollees: o The option of having their premiums deducted from their Social Security check or benefit; o The option of having their premiums paid by an electronic transfer mechanism (such as automatic charges of an account at a financial institution or a credit or debit card account); and o The option of paying their premium by check.
Medicare Managed Care Manual (Pub. 100-16), Ch. 4 § 10.5.1: Uniformity | Justis AI