HNE Medicare Advantage makes mid-year benefit changes only when Medicare changes its coverage rules. As a Medicare health plan, HNE Medicare Advantage must cover all services covered by Original Medicare.
When Medicare changes its coverage rules, Medicare issues a National Coverage Determination (NCD) explaining whether Medicare will pay for an item or service.
The chart below contains all mid-year changes to HNE Medicare Advantage health care benefits:
Effective Date |
National Coverage Determination |
Description of Benefit Change |
7/9/15 |
Screening for Cervical Cancer with Human Papillomavirus (HPV) Testing |
Effective July 9, 2015, Medicare has determined that the evidence is sufficient to add Human Papillomavirus (HPV) testing once every five years as an additional preventive service benefit under the Medicare program for asymptomatic
beneficiaries aged 30 to 65 years in conjunction with the Pap smear test. CMS will cover screening for cervical cancer with the appropriate U.S. Food and Drug Administration (FDA)
approved/cleared laboratory tests, used consistent with FDA approved labeling and in compliance with the Clinical Laboratory Improvement Act (CLIA) regulations.
|
| 7/1/15 | Discontinued Coverage of Vacuum Erection Systems (VES) Prosthetic Devices | Effective July 1, 2015, in Accordance with the Achieving a Better Life Experience Act of 2014 Section 203 of the Achieving a Better Life Experience (ABLE) Act of 2014 implements changes to treat VES prosthetic devices and related accessories as statutorily noncovered in the same manner that erectile dysfunction drugs are treated in Part D. |
| 4/13/15 | Screening for the Human Immunodeficiency Virus (HIV) Infection |
Effective April 13, 2015, Medicare will cover annual voluntary HIV screening for all beneficiaries age 15 to 65, and for beneficiaries younger than 15 and older than 65 |
2/5/15 |
Screening for Lung Cancer with Low Dose Computed Tomography (LDCT) |
Effective February 5, 2015, Medicare covers lung cancer screening with low dose computed tomography (LDCT) if all eligibility requirements listed in the National Coverage Determination (NCD) are met. |
It is our policy to post changes within 30 days of the effective date of the NCD. We will publish a notice in the next issue of the member newsletter.
All NCDs are effective on the date the decision memorandum is released (the date it is posted to the National Coverage Analysis page of the Medicare Coverage Center website at http://www.cms.gov/mcd/index_list.asp?list_type=nca. If the newly covered service is covered outside of the contract, the covered service may be obtained from any Medicare provider, including out-of-network providers.
To request printed copies or if you have any questions, please call Member Services at one of the numbers listed below.
H8578_2016_049 Approved
The information on this page was last updated on 04/22/2016