US · guidance
CMS Pub. 100-11, ch. 13, § 40.1
Definition of Premiums
The term “premiums” as used in this section does not include spenddown liability under
42 CFR § 435.121 and 42 CFR § 435.831, or post-eligibility treatment of income under
42 CFR § 460.184. A participant’s “share of cost” responsibility under Medicaid is not
considered a premium. PACE organizations may continue to collect any liability due to
them under Medicaid spenddown and post-eligibility processes, but that liability is not a
premium.
[71 FR 71322 (Dec. 8, 2006)]
History
(Rev. 2, Issued: 06-09-11; Effective: 06-03-11; Implementation: 06-03-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
9f33c09ce49d6cf81ca28539eded6c48490d4b68afb505e6180398b9f7742eef
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