Page:United States Statutes at Large Volume 111 Part 1.djvu/300

 Ill STAT. 276 PUBLIC LAW 105-33 —AUG. 5, 1997 "P ART C—^MEDICARE+CHOICE PROGRAM "E L IGIBILITY, ELECTION, AND ENROLLMENT 42 USC "SEC. 1851. (a) CHOICE OF MEDICARE BENEFITS THROUGH 1395W-21. MEDICARE+CHOICE PLANS.— "(1) IN GENERAL. — Subject to the provisions of this section, each Medicare+Choice eligible individual (as defined in paragraph (3)) is entitled to elect to receive benefits under this title— "(A) through the original medicare fee-for-service program under parts A and B, or "(B) through enrollment in a Medicare+Choice plan under this part. " (2) TYPES OF MEDICARE+CHOICE PLANS THAT MAY BE AVAIL- ABLE. —^A Medicare+Choice plan may be any of the following types of plans of health insurance: "(A) COORDINATED CARE PLANS.— Coordinated care plans which provide health care services, including but not limited to health maintenance organization plans (with or without point of service options), plans offered by provider-sponsored organizations (as defined in section 1855(d)), and preferred provider organization plans. "(B) COMBINATION OF MSA PLAN AND CONTRIBUTIONS TO MEDICARE+CHOICE MSA. —An MSA plan, as defined in section 1859(b)(3), and a contribution into a Medicare+Choice medical savings account (MSA). "(C) PRIVATE FEE-FOR-SERVICE PLANS.—A Medicare+Choice private fee-for-service plan, as defined in section 1859(b)(2). "(3) MEDICARE+CHOICE ELIGIBLE INDIVIDUAL. — "(A) IN GENERAL.—In this title, subject to subparagraph (B), the term 'Medicare+Choice eligible individual' means an individual who is entitled to benefits under part A and enrolled under part B. "(B) SPECIAL RULE FOR END-STAGE RENAL DISEASE.— Such term shall not include an individual medically determined to have end-stage renal disease, except that an individual who develops end-stage renal disease while enrolled in a Medicare+Choice plan may continue to be enrolled in that plan. "(b) SPECIAL RULES. — "(1) RESIDENCE REQUIREMENT.— "(A) IN GENERAL.— Except as the Secretary may otherwise provide, an individual is eligible to elect a Medicare+Choice plan offered by a Medicare+Choice organization only if the plan serves the geographic area in which the individual resides. " (B) CONTINUATION OF ENROLLMENT PERMITTED.— Pursuant to rules specified by the Secretary, the Secretary shall provide that a plan may offer to all individuals residing in a geographic area the option to continue enrollment in the plan, notwithstanding that the individual no longer resides in the service area of the plsin, so long as the plan provides that individuals exercising this option have, as part of the basic benefits described in section 1852(a)(1)(A), reasonable access within that geographic

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