Additional Expenses You Must Pay. In addition to your share of expenses as described above, you are responsible for payment of charges for: a. non-covered services; b. Prescription Drug Brand Additional Charges; and c. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage.
Appears in 25 contracts
Samples: Medical and Hospital Service Contract, Medical and Hospital Service Contract, Medical and Hospital Service Contract
Additional Expenses You Must Pay. In addition to your share of the expenses as described above, you are responsible for payment of charges for:
a. non-covered services;
b. Prescription Drug Brand Brand-Additional ChargesCharges (if your Plan includes pharmacy medication coverage); and
c. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage.
Appears in 2 contracts
Samples: Medical and Hospital Service Contract, Large Group Hmo Plan Medical and Hospital Service Contract
Additional Expenses You Must Pay. In addition to your share of the expenses as described above, you are responsible for payment of charges for:
a. non-covered services;
b. Prescription Drug Brand Additional Charges; and
c. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage.
Appears in 2 contracts
Samples: Medical and Hospital Service Contract, Non Group Medical and Hospital Service Contract
Additional Expenses You Must Pay. In addition to your share of expenses as described above, you are responsible for payment of charges for:
a. non-covered services;
b. Prescription Drug Brand Additional ChargesCharges (if your Plan includes prescription medication coverage); and
c. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage.
Appears in 1 contract
