Definitions 510-05-20-10 (Cost-Effective
Health Ins.)
(Revised 01/03 ML #2833)
(N.D.A.C. Section 75-02-02.1-12.1)
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For purposes of the cost-effective health insurance sections:
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"Cost-effective" means that Medicaid payments for a set of Medicaid-covered services would likely exceed the cost of paying the health plan premium, coinsurance charges, and deductibles for those services.
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"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.