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Managed Care Committee Reimbursement TIDBITS

Featuring this month: Medicare Advantage Plans

TidBits thanks to

MSHO Crazy Lady


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.



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