Enrollee Choice Sample Clauses
The Enrollee Choice clause grants individuals the right to select from available options within a program, plan, or service. In practice, this may allow enrollees to choose their preferred healthcare provider, insurance plan, or benefit package, depending on the context of the agreement. This clause ensures that participants have autonomy and flexibility, addressing the need for personal preference and suitability in their selections.
Enrollee Choice. (A) The Department shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all health plans available in the Service Area.
(B) The Department will inform Potential Enrollees of Medicaid benefits.
(C) The Medicaid Eligible Individual’s intent to enroll is established when the applicant selects the Contractor, either verbally or by signing a choice of health care delivery form or equivalent. If the Enrollee does not choose a Health Plan, the Department may automatically assign the Enrollee to a health plan based on a methodology approved by CMS. This initiates the action to send an advance notification to the Contractor.
(D) Medicaid enrollees made eligible for a retroactive period prior to the current month are not eligible for Contractor enrollment during the retroactive period.
Enrollee Choice. (A) The Department shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all Dental Plans available in the Service Area. If the Enrollee does not select a Dental Plan, the Department shall assign the Enrollee a Dental Plan.
(B) The Department shall certify and the Contractor agrees to accept the individuals who are eligible to be enrolled in the Medicaid program.
(C) Each Enrollee can be enrolled or disenrolled in a Dental Plan independent of the enrollment or disenrollment of any Family Member.
(D) If more than one Dental Plan is available, on an annual basis, Enrollees shall be permitted to transfer from one Dental Plan to another without cause during the Department-defined open enrollment period.
(E) The Department may, at any time, revise its enrollment procedures. The Department will advise the Contractor of the anticipated changes in advance whenever possible. The Contractor shall have the opportunity to make comments and provide input on the changes. The Contractor shall be bound by the changes in enrollment procedures.
Enrollee Choice. (A) The Department or the Department’s designee shall determine a Potential Enrollee’s eligibility for Enrollment and will offer Potential Enrollees a choice among all available Dental Plans. If the Enrollee does not select a Dental Plan, then the Department will assign the Enrollee to a Dental Plan.
(B) The Department shall certify and the Contractor agrees to accept the individuals who are eligible to be enrolled in the CHIP program. The Contractor shall enroll individuals in the order in which they apply.
(C) Each Enrollee can be enrolled or disenrolled in a Dental Plan independent of the enrollment or disenrollment of any other children in the family.
(D) On an annual basis, Enrollees shall be permitted to transfer from one Dental Plan to another without cause during the Department-defined open enrollment period.
(E) The Department may, at any time, revise its enrollment procedures. The Department will advise the Contractor of the anticipated changes in advance whenever possible. The Contractor shall have the opportunity to make comments and provide input on the changes. The Contractor shall be bound by the changes in enrollment procedures.
Enrollee Choice. (A) The Department or the Department’s designee shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all Health Plans available in the Service Area. If the Enrollee does not select a Health Plan, then the Department will assign the Enrollee to a Health Plan.
(B) The Department will inform Potential Enrollees of CHIP benefits.
(C) The CHIP Eligible Individual’s intent to enroll is established when the applicant selects the Contractor, either verbally or by signing a choice of health care delivery form or equivalent. If the Enrollee does not choose a Health Plan, the Department shall automatically assign the Enrollee to a Health Plan based on a methodology approved by CMS. This initiates the action to send an advance notification to the Contractor.
(D) The Department may, at any time, revise its enrollment procedures. The Department will advise the Contractor of the anticipated changes in advance whenever possible. The Contractor shall have the opportunity to make comments and provide input on the changes. The Contractor shall be bound by the changes in enrollment procedures.
Enrollee Choice. (A) The Department or the Department’s designee shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all Integrated Care Plans available in the Service Area.
(B) The Department will inform Potential Enrollees of Medicaid benefits.
(C) The Medicaid Eligible Individual’s intent to enroll is established when the applicant selects the Contractor, either verbally or by signing a choice of health care delivery form or equivalent. If the Enrollee does not choose an Integrated Care Plan, the Department shall automatically assign the Enrollee to an Integrated Care Plan based on a methodology approved by CMS. This initiates the action to send an advance notification to the Contractor.
(D) Enrollees made eligible for a retroactive period prior to the current month are not eligible for Contractor enrollment during the retroactive period.
Enrollee Choice. (A) The Department shall determine eligibility for Enrollment. If more than one Dental Plan is available the Department will offer Potential Enrollees a choice among all available Dental Plans. If the Enrollee does not select a Dental Plan, then the Department will assign the Enrollee to a Dental Plan.
(B) The Department shall certify and the Contractor agrees to accept the individuals who are eligible to be enrolled in the CHIP program.
(C) Each Enrollee can be enrolled or disenrolled in a Dental Plan independent of the enrollment or disenrollment of any Family Member.
(D) If more than one Dental Plan is available, on an annual basis, Enrollees shall be permitted to transfer from one Dental Plan to another without cause during the Department-defined open enrollment period.
(E) The Department may, at any time, revise its enrollment procedures. The Department will advise the Contractor of the anticipated changes in advance whenever possible. The Contractor shall have the opportunity to make comments and provide input on the changes. The Contractor shall be bound by the changes in enrollment procedures.
Enrollee Choice. (A) The Department or the Department’s designee shall determine a Potential Enrollee’s eligibility for Enrollment and will offer Potential Enrollees a choice among all available Health Plans. If the Enrollee does not select a Health Plan, then the Department will assign the Enrollee to a Health Plan.
(B) The Department shall certify and the Contractor agrees to accept the individuals who are eligible to be enrolled in the CHIP program. The Contractor shall enroll individuals in the order in which they apply.
(C) Each Enrollee can be enrolled or disenrolled in a Health Plan independent of the enrollment or disenrollment of any other children in the family.
(D) On an annual basis, Enrollees shall be permitted to transfer from one Health Plan to another without cause during the Department-defined open enrollment period.
(E) The Department may, at any time, revise its enrollment procedures. The Department will advise the Contractor of the anticipated changes in advance whenever possible. The Contractor shall have the opportunity to make comments and provide input on the changes. The Contractor shall be bound by the changes in enrollment procedures.
Enrollee Choice. Potential enrollees in the MMA regions will initially have the choice of enrolling in a plan. Potential enrollees will have a choice of two or more plans in each region. The Agency assures Centers for Medicare and Medicaid Services that it will comply with section 1932(a)(3) of the Social Security Act (SSA) and 42 Code of Federal Regulations (CFR) 438.52, relating to choice since at least two options will be available in all MMA regions.
Enrollee Choice. The Department or the Department’s designee shall determine eligibility for Enrollment and will offer Potential Enrollees a choice among all Health Plans available in the Service Area.
Enrollee Choice. (A) The Contractor shall have a continuous open enrollment period for new Enrollees. Enrollment is open to any qualified Medicaid Eligible Individual who meets the eligibility requirements for enrollment. The Department shall certify, and the Contractor agrees to accept, individuals who are eligible to be enrolled in the Health Plan. Contractor shall accept Enrollees in the order in which they apply.
(B) New Enrollees shall be selected based upon the eligibility requirement that the Medicaid Eligible Individual has a development disability that is medically complex with major developmental challenges due to mental illness or behavioral problems.
(C) Enrollees may be made retroactively eligible up to 6 months.