About Your Agreement. All Benefits in this Plan are limited, as We show You on the Schedule of Benefits and other parts of this Contract. Your Schedule of Benefits tells You specific financial information about Your Plan. It tells You the percentage of Allowable Charges We pay when You have Covered Services. It includes the Lifetime Maximum Payment amounts. This Plan covers You if You receive treatment for the following Covered Diseases: ◼ Cancer (any type or kind) ◼ Poliomyelitis ◼ Leukemia ◼ Diphtheria ◼ Tetanus ◼ Spinal Meningitis (Meningococci) ◼ Scarlet Fever ◼ Small Pox ◼ Polio ◼ Tularemia ◼ Encephalitis (Sleeping Sickness) ◼ Rabies ◼ Sickle Cell Anemia When You file a Claim, first We figure the amount We pay as Our Coinsurance percentage of the Allowable Charges for Covered Services. Then We will pay Benefits, up to the maximum amount for Your lifetime. To be covered by this Plan, an attending Physician must prescribe the services to treat the Member’s Covered Diseases. The Plan does not cover other illnesses. Under certain circumstances, if We learn that We mistakenly paid a Provider amounts that You should have paid ⎯ such as if We paid part of Your Coinsurance ⎯We may collect those amounts directly from You. You agree that We have the right to do so.
Appears in 6 contracts
Samples: Limited Benefit Contract, Cancer and Serious Disease Limited Benefit Contract, Limited Benefit Contract
About Your Agreement. All Benefits in this Plan are limited, as We show You on the Schedule of Benefits and other parts of this Contract. Your Schedule of Benefits tells You specific financial information about Your Plan. It tells You the percentage of Allowable Charges We pay when You have Covered Services. It includes the Lifetime Maximum Payment amounts. This Plan covers You if You receive treatment for the following Covered Diseases: ◼ Cancer (any type or kind) ◼ Poliomyelitis ◼ Leukemia ◼ Diphtheria ◼ Tetanus ◼ Spinal Meningitis (Meningococci) ◼ Scarlet Fever ◼ Small Pox ◼ Polio ◼ Tularemia ◼ Encephalitis (Sleeping Sickness) ◼ Rabies ◼ Sickle Cell Anemia When You file a Claim, first We figure the amount We pay as Our Coinsurance percentage of the Allowable Charges for Covered Services. Then We will pay Benefits, up to the maximum amount for Your lifetime. To be covered by this Plan, an attending Physician must prescribe the services to treat the Member’s Covered Diseases. The Plan does not cover other illnesses. Under certain circumstances, if We learn that We mistakenly paid a Provider amounts that You should have paid ⎯ such as if We paid part of Your Coinsurance ⎯We We may collect those amounts directly from You. You agree that We have the right to do so.
Appears in 2 contracts
Samples: Cancer and Serious Disease Limited Benefit Contract, Limited Benefit Contract
