See Medicaid Managed Care Model Contract, Appendix K at the end of this chapter.
Glossary terms found on this page:
A legal agreement between an individual member or an employer group and a health plan that describes the benefits and limitations of the coverage.
Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.
Any form of health plan that uses selective provider contracting to have patients seen by a network of contracted providers and that requires prior approval of certain services.
A jointly funded federal and state program that provides hospital and medical coverage to the low-income population and certain aged and disabled individuals.