Current through September 2, 2024
Section 16.03.17.010 - DEFINITIONS01.Department. The Idaho Department of Health and Welfare or designee.02.Dual-Eligible. Individuals meeting eligibility requirements under Section 100 of these rules.03.Fully Integrated Dual-Eligible Special Needs Plan (FIDE-SNP). A health plan fully integrating care for dual-eligible participants under a single MAO.04.Idaho Medicaid Plus (IMPlus). A health plan option for certain dual-eligible participants where Medicaid covered services are provided under a managed care organization, under IDAPA 16.03.10, "Medicaid Enhanced Plan Benefits," Sections 076 through 079.05.Evidence of Coverage. The Medicare Advantage Plan contract between the MAO and the participant that explains the covered services, including services under Medicare Parts A, B, and D.06.Medicare Advantage Organizations (MAOs). Insurance companies approved by the Centers for Medicare/Medicaid Services (CMS) to offer Medicare Advantage Plans.07.Medicare Advantage Plan. A private health plan approved by and contracted with CMS to provide Medicare Parts A, B, and D benefits as described in its "Evidence of Coverage."08.Medicare/Medicaid Coordinated Plan (MMCP). FIDE-SNP for certain dual-eligible participants integrating Medicare and Medicaid covered services under one (1) managed care organization.Idaho Admin. Code r. 16.03.17.010