Section 16.03.17.300 - MMCP: COVERAGE AND LIMITATIONSAn MMCP is subject to applicable federal managed care requirements.
01.MMCP-Covered Services. Include:a. MAO-Covered Services. Under the "Evidence of Coverage," the MAO may limit or expand the scope of services as defined in the "Evidence of Coverage." MAO-covered services, including Medicare Parts A, B, and D benefits, are detailed in the MMCP contract.b. Medicaid-Only Services. Under IDAPA 16.03.09, "Medicaid Basic Plan Benefits," or IDAPA 16.03.10, "Medicaid Enhanced Plan Benefits," provided by Medicaid providers that are not MAOs. Medicaid may cover additional services that are not included in the MAO's "Evidence of Coverage."c. Supplemental services unavailable on Medicare or Medicaid.02.Services Excluded from the MMCP. Services not included in the MAO's "Evidence of Coverage" or listed under Subsection 300.01 of this rule are not covered under the MMCP.03.Premiums and Cost-Sharing. Participants will not pay any premiums or cost-sharing when covered under the MMCP, except as described in an approved MMCP contract.Idaho Admin. Code r. 16.03.17.300