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Clinical Coverage Criteria References
When Medicare does not fully define coverage for a service through statute, regulation, National Coverage Determinations, or Local Coverage Determinations, we use clinical coverage criteria based on current evidence, treatment guidelines, and clinical literature. These criteria comply with CMS requirements and are publicly available.
Total
EasyCare Plus
EasyCare
Dental Services (Coming Soon)
Total
EasyCare Plus
EasyCare
Medical Necessity and Other Clinical Coverage Criteria (Coming Soon)
EasyCare
Total
EasyCare Plus
Outpatient Physical, Occupational, and Speech Therapy Coverage Guideline
Download PDF:
Annual Notice of Change
EasyCare Plus
Annual Notice of Change
Summary of Benefits