Annual Deductible. Covered Services may be subject to an annual Deductible. Charges subject to the annual Deductible shall be borne by the Subscriber during each year until the annual Deductible is met. Covered Services must be received from a Network Provider at a Network Facility, unless the Member has received Preauthorization or has received Emergency services. There is an individual annual Deductible amount for each Member and a maximum annual Deductible amount for each Family Unit. Once the annual Deductible amount is reached for a Family Unit in a calendar year, the individual annual Deductibles are also deemed reached for each Member during that same calendar year.
Annual Deductible. Note: Covered Services may be subject to an annual Deductible. The annual Deductible amount a Member must pay is determined by whether the Member is a sole Subscriber or has enrolled Dependents.
a. Subscriber Only Coverage (individual coverage).
b. Family Coverage (coverage for the Subscriber plus one (1) or more Dependents).
Annual Deductible. Companion accommodation We will pay for companion accommodation when the member is receiving eligible in-patient treatment within the area of cover. up to S$190 per night Annual Deductible New Born accommodation This benefit pays for the child who is less than 16 weeks to stay in the hospital while the insured mother is receiving eligible in-patient treatment. Included Annual Deductible Cash benefit Payable for eligible in-patient treatment only when the member receives treatment within area of cover and provided no cost for that treatment is claimed under this plan. S$200 per night Annual Deductible In-patient Rehabilitation This benefit pays for in-patient rehabilitation when: a) it is carried out by a medical practitioner specialising in rehabilitation; and b) it is carried out in a rehabilitation hospital or unit which is recognised by us; and c) the treatment could not be carried out on an out-patient basis, and d) the costs have been agreed, in writing by us before the rehabilitation begins. We will not pay for in-patient rehabilitation for more than twenty-eight (28) days except in cases such as in severe central nervous system damage caused by external trauma. For cases such as in severe central nervous system damage caused by external trauma, we will not pay for in-patient rehabilitation for more than one hundred eighty (180) days. Included Annual Deductible Pre-hospitalisation treatment (up to 90 days before admission) We will pay for consultation, prescribed investigations and essential medications received as an out-patient within 90 days prior to a hospitalisation, where such hospitalisation is eligible for cover under member’s plan and where the need for such hospitalisation has arisen as a direct result of the medical examination and investigation findings drawn from that consultation. Included Annual Deductible Post hospitalisation treatment (within 90 days after discharge) This benefit pays for follow-up out-patient consultation and treatment following an eligible in-patient or daycare surgery when such consultation is carried out by the in-patient treating medical practitioner or a referred medical practitioner and provided such consultation or treatment occurs within 90 days following the discharge from hospital or the date of the daycare surgery. Included Annual Deductible Primary and Specialist care This benefit pays for consultation, diagnostic procedures, prescribed drugs and dressings received as part of an out-patient treatment. Di...
Annual Deductible. Certain services are subject to an Annual Deductible. This is the amount a Member must pay each Calendar Year for Covered Services before some Covered Services are paid under this Contract. It is also referred to as the Deductible. Please refer to Your Schedule of Benefits. Not all Covered Services are subject to the Deductible such as most Preventive Services. Your Plan’s Copayment amounts do not apply towards Your Deductible. Please refer to Your Schedule of Benefits for Your Plan’s Deductible amounts and for information about which services are not subject to the Deductible. Copayments and penalties are not considered when determining if You have satisfied Your Deductible. You have an individual Deductible. Once Your individual Deductible has been met, the Plan will pay benefits for Your Covered Services. Refer to Your Schedule of Benefits for Your Deductible amount. If You have enrolled in family coverage, or coverage for two (2) or more people; Your Plan has a Family Deductible. Some Covered Services will not be eligible for payment by the Plan until either the Per-Person Deductible or the Family Deductible has been met. Amounts paid by any Member in Your family toward their Per-Person Deductible will also apply to the Family Deductible. For example, if the individual Member’s Per-Person Deductible is $500, then up to $500 per Member can be applied to the Family Deductible. Once the Family Deductible has been met no Per-Person Deductible will apply and We will pay for Covered Services. Changes to the Deductible may only be made at renewal. Your Plan includes an Annual Out-of-Pocket Maximum to protect You and Your Dependents from the high cost of a catastrophic event. The Annual Out-of-Pocket Maximum is the most You will pay for Cost Sharing in a Calendar Year for certain Covered Benefits. Please refer to Your Schedule of Benefits for the Out-of-Pocket Maximum. Only Deductibles, Coinsurance, and Copay amounts paid out of Your pocket for Covered Benefits are applied to the Annual Out-of–Pocket Maximum. Once this amount is met then Covered Benefits are paid at 100% for the remainder of the Calendar Year. Deductibles and Copays amounts paid for vision services that are not Essential Health Benefits do not apply toward this Plan Out-of-Pocket Maximum as well. Once Your Deductible is satisfied, the Copay payments that You pay for Covered Services will apply to Your Out-of-Pocket Maximum. Amounts or services that do not apply to Your Out-of- Pocket Maximum a...
Annual Deductible. The Alvogen Indemnitees shall only be entitled to indemnification pursuant to this Article XI (excluding claims made under clause (f) of Section 11.2 and clause (f) of Section 11.1) for Losses incurred in a given Annual Period to the extent the aggregate amount of such Losses incurred by the Alvogen Indemnitees in such Annual Period and for which the Alvogen Indemnitees are entitled to indemnification pursuant to this Article XI (excluding Losses relating to clause (f) of Section 11.2 and clause (f) of Section 11.1) exceeds [***]% of the aggregate amount paid by Alvogen to Pfenex in such Annual Period. The Pfenex Indemnitees shall only be entitled to indemnification pursuant to this Article XI (excluding claims made under clause (f) of Section 11.2 and clause (f) of Section 11.1) for Losses incurred in a given Annual Period to the extent the aggregate amount of such Losses incurred by the Pfenex Indemnitees in such Annual Period and for which the Pfenex Indemnitees are entitled to indemnification pursuant to this Article XI (excluding Losses relating to clause (f) of Section 11.2 and clause (f) of Section 11.1) exceeds [***]% of the aggregate amount paid by Alvogen to Pfenex hereunder in such Annual Period.
Annual Deductible. For Year 1 this Agreement, there will be an annual, employee-paid deductible of five hundred fifty dollars ($500) for individual coverage and seven hundred fifty dollars ($750) for family coverage. For Years 2 and 3 of this Agreement, there will be an annual, employee-paid deductible of seven hundred fifty dollars ($750) for individual coverage and one thousand five hundred dollars ($1500) for family coverage.
Annual Deductible. Effective January 1, 2012 the annual Extended Health Deductible shall be reduced to seventy-five dollars ($75.00) per person or family each calendar year.
Annual Deductible. Effective January 1, 2023, increase annual deductible from $90 to $100.
Annual Deductible a. MHCN. Covered Services received from a MHCN Provider are subject to the annual Deductible as set forth in the Allowances Schedule.
Annual Deductible. An annual deductible of $25.00 shall first be paid by the employee. The plan pays remaining eligible expenses up to a lifetime maximum of $400,000 for any one person with restoration as provided by the plan/Company. Note: * The major medical benefit covers the portions of the above expenses that are not furnished under governmental or Corporation supported plans, e.g., OHIP, Worker’s Compensation, etc…
