Common use of Additional Expenses You Must Pay Clause in Contracts

Additional Expenses You Must Pay. In addition to your share of the expenses described above, you are responsible for payment of charges for: a. non-covered services; b. Prescription Drug Brand Additional Charges (if your Plan includes pharmacy medication coverage); c. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage; and d. charges in excess of the Maximum Allowable Payment for Covered Services rendered by Non- Participating Providers who have not agreed to accept our Maximum Allowable Payment as payment in full. Except in the case of emergencies, a Member who chooses a Non-Participating Provider may be responsible to pay an amount that exceeds the Maximum Allowable Payment for the particular Health Care Services involved, in addition to the applicable Deductible and Coinsurance amounts. Also, fees that are in excess of allowable charges are not a Covered Benefit and therefore do not apply to your Deductible or annual out-of-pocket expense.

Additional Expenses You Must Pay. In addition to your share of the expenses described above, you are responsible for payment of charges for: a. non-covered services; b. Prescription Drug Brand Additional Charges (if your Plan includes pharmacy medication coverage)Charges; c. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage; and d. charges in excess of the Maximum Allowable Payment for Covered Services rendered by Non- Participating Providers who have not agreed to accept our Maximum Allowable Payment as payment in full. Except in the case of emergencies, a Member who chooses a Non-Participating Provider may be responsible to pay an amount that exceeds the Maximum Allowable Payment for the particular Health Care Services involved, in addition to the applicable Deductible and Coinsurance amounts. Also, fees that are in excess of allowable charges are not a Covered Benefit and therefore do not apply to your Deductible or annual out-of-pocket expense.

Additional Expenses You Must Pay. In addition to your share of the expenses described above, you are responsible for payment of charges for: a. non-covered services; b. Prescription Drug Brand Brand-Additional Charges (if your Plan includes pharmacy medication coverage)Charges; c. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage; and d. charges in excess of the Maximum Allowable Payment for Covered Services rendered by Non- Participating Providers who have not agreed to accept our Maximum Allowable Payment as payment in full. Except in the case of emergencies, a Member who chooses a Non-Participating Provider may be responsible to pay an amount that exceeds the Maximum Allowable Payment for the particular Health Care Services Service involved, in addition to the applicable Deductible and Coinsurance amounts. Also, fees that are in excess of allowable charges are not a Covered Benefit and therefore do not apply to your Deductible or annual out-of-pocket expense.

Additional Expenses You Must Pay. In addition to your share of the expenses described above, you are responsible for payment of charges for: a. i. non-covered services; b. ii. Prescription Drug Brand Additional Charges (if your Plan includes pharmacy medication coverage); c. iii. expenses for Claims denied because we did not receive information requested from you regarding any other coverage and the details of such coverage; and d. iv. charges in excess of the Maximum Allowable Payment for Covered Services rendered by Non- Participating Providers who have not agreed to accept our Maximum Allowable Payment as payment in full. Except in the case of emergencies, a Member who chooses a Non-Participating Provider may be responsible to pay an amount that exceeds the Maximum Allowable Payment for the particular Health Care Services involved, in addition to the applicable Deductible and Coinsurance amounts. Also, fees that are in excess of allowable charges are not a Covered Benefit and therefore do not apply to your Deductible or annual out-of-pocket expense.