05/18/2022
Managed Care Committee Reimbursement TIDBITS
Featuring this month: Medicare Advantage Plans
TidBits thanks to
MSHO
Did you know.... Medicare Advantage plans MUST cover all of the medically necessary services that original Medicare covers! With that said, they can reimburse differently, require prior authorization, and are allowed step edits for drugs that are EQUALLY EFFECTIVE.
Did you know... Medicare Advantage Plans can’t charge more than Original Medicare for certain services, like chemotherapy, dialysis, and skilled nursing facility care!
Did you know... The "Medicare and You" booklet has a WONDERFUL comparison of traditional Medicare and Medicare Advantage. CLICK HERE to download and review the PDF Booklet!!
NOTE: A different Michigan Payer will be featured monthly.
Visit the MSHO Website for a listing of the Michigan Health Plans and the MSHO Managed Care Committee.