Medicare Cost Plans
Medicare Cost Plans are a type of Medicare health plan, similar to an HMO, in which enrollees can receive services outside the plan's network that are billed to Original Medicare, with the beneficiary responsible for traditional Medicare cost-sharing. In-network services are covered by the plan.
Definition
Medicare Cost Plans are a type of Medicare health plan, similar to an HMO, in which enrollees can receive services outside the plan's network that are billed to Original Medicare, with the beneficiary responsible for traditional Medicare cost-sharing. In-network services are covered by the plan.
Why it matters
Their hybrid coverage rules affect how and to whom home health and other services are billed, so verifying plan type prevents claim errors.
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Episodes from Inside Home Health that put Medicare Cost Plans in operational context.
