National Coverage Determinations
As a Medicare health plan, Health New England Medicare Advantage covers all services required by Original Medicare. We only make mid-year benefit changes when Medicare changes its coverage rules. When this happens, Medicare issues a National Coverage Determination (NCD) explaining whether Medicare will pay for an item or service. It is our policy to post changes within 30 days of the effective date of the NCD. All NCDs are effective on the date the decision memorandum is released. If the newly covered service is covered outside of the contract, the covered service may be obtained from any Medicare provider, including out-of-network providers.