Member Policy

2017 MDwise Marketplace Sample Member Policy

Click here to see a sample of a MDwise Marketplace member policy for 2017.
  • Definitions.
  • Eligibility, enrollment and effective date of coverage.
  • Benefits and covered health services/non-covered health services.
  • Exclusions.
  • Premium payment.
  • Procedures for obtaining health services.
  • Procedures for reimbursement of allowed amounts.
  • Grievance procedures.
  • Renewability and termination.
  • Recovery source/subrogation.
  • Coordination of benefits.
  • General provisions.
  • Schedule of benefits.