108 CMR, § 10.04 - Eligibility
The definitions and methods of determining reimbursements contained herein are regulations promulgated by the DHCFP. All fee schedules that are changed and promulgated by the DHCFP will be sent to all veterans' agents as the changes occur.
(1)
Unlimited Medical Benefits. Medical services for
eligible veterans and their dependents who are unemployable, permanently
disabled, in receipt of Social Security, VA pension, or other retirement
pensions shall be all benefits that are currently included in 114.3
CMR.
(2)
Limited
Medical Benefits. Medical services for eligible veterans and their
dependents who are in receipt of ordinary benefits because of unemployment or
illness, but who are expected to return to employment, shall be limited to
emergency cases or cases of elimination of pain. All other cases considered
medically essential require prior approval by the Secretary.
Notes
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