English_AIAN-Limited-Cost-Sharing_Final_01.28.25 (clean)

Summary of Benefits and Coverage and Uniform Glossary (CMS-10407)

English_AIAN-Limited-Cost-Sharing_Final_01.28.25 (clean)

OMB: 0938-1146

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleSummary of Benefits and Coverage Example AI/AN Limited Cost Sharing
SubjectExample SBC of AI/AN Limited Cost Sharing
KeywordsSBC, Summary, of, Benefits, and, Coverage, deductible, services, out-of-pocket, limit, network, provider, referral, specialist, cost, sharing
AuthorCMS
File Created2025:07:27 17:02:42Z

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