May 10, 2010

Supplemental 2011 Medicare Advantage Benefits Policy Memo on Application of the Mandatory Maximum Out-of-Pocket for Dual Eligible SNPs & Cost Sharing for Preventive Services

This report, written by Danielle R. Moon, J.D., M.P.A., Director of the Medicare Drug and Health Plan Contract Administration Group, provides additional, clarifying information for Medicare Organizations, 1876 Cost Plans, and Demonstrations related to application of the mandatory Out of Pocket Maximum(MOOP) for dual-eligible Special Needs Plans (D-SNPs) and preventive services cost sharing. The two main topics of this report are the Application of the Mandatory Maximum Out-Of-Pocket Limit for Dual Eligible (DE) Beneficiaries Enrolled in MA Plans and Preventive Services.