MLN8659122 - Original Medicare vs. Medicare Advantage
This new Product comprises Subregulatory Guidance for Original Medicare vs Medicare Advantage, and its content is based on publicly available content within https://www.medicare.gov/sign-up-change-plans/types-of-medicare-health-plans/other-medicare-health-plans, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-422/subpart-A/section-422.4, https://www.medicare.gov/claims-appeals/how-to-file-a-complaint-grievance, https://www.cms.gov/Medicare/Appeals-and-Grievances/MMCAG/BFCC-QIO-Review, https://www.cms.gov/Medicare/Appeals-and-Grievances/MMCAG/Downloads/Parts-C-and-D-Enrollee-Grievances-Organization-Coverage-Determinations-and-Appeals-Guidance.pdf, https://www.medicare.gov/claims-appeals/how-do-i-file-an-appeal, and https://www.cms.gov/Medicare/Appeals-and-Grievances/MMCAG. CMS policy or operation subject matter experts also reviewed/cleared this product. This product educates providers on how original Medicare differs from Medicare Advantage, basic types of Medicare Advantage plans, claims processing, grievances, and appeals.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 21, 2021
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.