US · guidance
CMS Pub. 100-16, ch. 4, § 120.2
Requirements, Rights, and Beneficiary Protections
All requirements, rights, and protections that apply to the MA program also apply to all
MA plan benefits – that is, the basic, mandatory and optional supplemental benefits
discussed in this chapter. By contrast, the employer, labor organization, fund trustees or
State Medicaid benefits that complement the MA plan benefits are not considered MA
benefits and are therefore beyond the scope of MA regulations. Marketing materials
associated with the complementary benefits are also not subject to CMS approval. (See
the Medicare Marketing Guidelines for further discussion at:
https://www.cms.gov/Medicare/Health-Plans/ManagedCareMarketing/Downloads/2016-
Medicare-Marketing-Guidelines-Updated.pdf.)
Medicaid benefits provided through a contract with an MAO to provide coverage for
individuals eligible for both Medicare and Medicaid and who are enrolled in an MA plan
are subject to Medicaid rules and regulations, including CMS review where applicable.
History
(Rev. 121, Issued: 04-22-16, Effective: 04-22-16, Implementation: 04-22-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
67ca04f0d990678676b807f581c4626e81dc376eb373b801b9542453ace544e1
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