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Medicare Cost Plans

Medicare Cost Plans


A Cost Contract provides the full Medicare benefit package. Payment is based on the reasonable cost of providing services. Beneficiaries are not restricted to the HMO or CMP to receive covered Medicare services, i.e. services may be received through non-HMO/CMP sources and are reimbursed by Medicare intermediaries and carriers.

Organizations that have current Medicare Advantage Cost Contracts with CMS can download operational policy information and updates below. Organizations that would like to apply for a Medicare Advantage Cost Contract must download and complete the application below. The Application Form file provides instructions on how to use each file. Files can be viewed and downloaded in .zip format.


ID NumberIssueStatusIssuedSubject
03-001Notice requirements for hospitals/SNF denialsPending03/25/03Appeals
03-013Medicare Appeal RulesPending06/27/03Appeals
03-015Tracking Out-of-Pocket MaximumPending01/13/04Appeals
Medicare Cost Application (Zip, 349 KB)

Comparison Chart - Medicare Cost and Medicare Adantage Programs (Zip, 345 KB)

Cost Plan Policy Index Pt.1 (Zip, 676 KB)

Cost Plan Policy Index Pt.2 (Zip, 15 KB

Effective Date of Cost Plan Enrollment - New Policy Option - Revised (pdf, 141 KB)

Effective Date of Cost Plan Enrollment - New Policy Option (pdf, 132 KB)

Issuance of Noncoverage Notices by Cost Plans for Inpatient Hospital Discharges (pdf, 107 KB)
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Page Last Modified: 09/03/2008 9:47:41 AM
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