US · guidance
CMS Pub. 100-16, ch. mc86c17f, § 10.13
Part B Services from a Non Plan Provider
(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)
When a Medicare Cost Plan is legally obligated to cover services provided by a non-plan
provider, who provided plan-covered part B services to one of its enrollees, then the cost
plan must indemnify the member from incurring liability greater than the cost sharing
due under the plan. In such a case, the deductibles and co-insurance normally due under
original Medicare must be reduced by the plan on behalf of the enrollee to the cost
sharing amounts that otherwise apply in the Medicare Cost Plan for such services.
History
(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
5e5a521012206ddef0d17bb07c241597f3efdd95533626b007ee7ce390832046
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