HI 00610.460 Group Practice Prepayment Plan

A special rule is applied to calculate the deductible for members of a Group Practice Prepayment Plan (GPPP) which deals directly with CMS. Once a month, CMS credits each plan member with a fixed portion of the premium toward the deductible for that year. If in any year a member uses only covered services furnished by the plan, the deductible will be fully covered.

If during the year, an individual receives covered services which are not provided by the plan, credit toward the Part B cash deductible at that time will depend on the accumulated credits for the months of the year in which the individual has paid premiums to the plan and any other expenses incurred by the individual which count toward meeting the deductible.