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CMS Pub. 100-16, ch. mc86c17f, § 20.1

General Guidelines for Benefits

activein force · 2026-08-25 – presentas-observed

(Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05)

All benefits that are part of the Medicare Cost Plan must satisfy the following guidelines:

• All benefits must be directly health-related, that is, health care services or items

whose primary purpose is to prevent or cure, actual or imminent, illness or injury

for which the MA plan incurs a cost that is not solely administrative;

• All benefits must be offered uniformly to all enrollees;

• All benefits must be explicitly mentioned in the appropriate marketing vehicles.

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
a27ccaf6eded08c4f93e6718a75b5aabeaec17cb770a516af407f6ccc281d979
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CMS Pub. 100-16, ch. mc86c17f, § 20.1 — General Guide… · binding.law