Managed Care For Duals: Coverage And Limitations

01. Coverage. All MMCP plan options include Medicaid-only Basic and Enhanced Plan services provided by Medicaid providers that are not MAOs. Medicaid may cover additional services not included in the MCO’s Evidence of Coverage. MAOs providing MMCP plans may limit or expand MAO-covered services, including Medicare Parts A, B, and D benefits or supplemental services unavailable on Medicaid or Medicare, as detailed in the contract and Evidence of Coverage. (7-1-26) 02. Limitations. Services not included in the Evidence of Coverage are carved out and provided under fee-for-service Medicaid or other contracted entities. (7-1-26) 975. – 979. (RESERVED) INVESTIGATIONS, AUDITS, AND ENFORCEMENT (Sections 980 - 999) SUB AREA: LIENS AND ESTATE RECOVERY (Sections 980-989) 980. (RESERVED)