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42 U.S.C. § 1395ss–1Clarification

submitted 18 years ago by Pub. L. 110-275 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 98 words · no verdicts yet

in plain englishAI-generated · not legal advice

A health insurance policy must follow section 1882(o) of the Social Security Act if it reimburses expenses for items or services that Medicare may pay for, but Medicare Advantage limits such payment through deductibles, coinsurance, copayments, or other limits. This rule applies to Medicare Advantage plans, including private fee-for-service plans.

Any health insurance policy that reimburses expenses for items or services for which payment may be made under title XVIII of the Social Security Act, but that are not reimbursable because a Medicare Advantage plan under part C of that title applies deductibles, coinsurance, copayments, or other limits, must meet the requirements of section 1882(o) of that Act. This includes a Medicare Advantage private fee-for-service plan. This section does not define the terms “health insurance policy,” “Medicare Advantage plan,” “deductibles,” “coinsurance,” “copayments,” or “other limitations.”
the actual law source: uscode.house.gov ↗public domain

Any health insurance policy that provides reimbursement for expenses incurred for items and services for which payment may be made under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.] but which are not reimbursable by reason of the applicability of deductibles, coinsurance, copayments or other limitations imposed by a Medicare Advantage plan (including a Medicare Advantage private fee-for-service plan) under part C of such title [42 U.S.C. 1395w–21 et seq.] shall comply with the requirements of section 1882(o) of the such 1 Act (42 U.S.C. 1395ss(o)).

Source credit: (Pub. L. 110–275, title I, § 104(c), July 15, 2008, 122 Stat. 2502.)

history & why it existsrecord from the source credit
  • 2008Enacted · Pub. L. 110-275 · 122 Stat. 2502

A history note hasn’t been published yet. The record shows enactment by Pub. L. 110-275 on 2008-07-15.

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