Definitions 510-05-20-10 (Cost Effective Health Ins.)

(Revised 2/04 ML #2900)

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(N.D.A.C. Section 75-02-02.1-12.1)

For purposes of the cost-effective health insurance sections:

"Cost-effective" means that Medicaid payments for a set of Medicaid-covered services are likely to exceed the cost of paying the health plan premium, coinsurance charges, and deductibles for those services.

"Health plan" means any plan under which a third party is obligated by contract to pay for health care provided to an applicant for or recipient of Medicaid.