Annual Maximum. This Contract has an annual maximum for Adult Dental Care benefits described in the Adult Dental Care section of this Contract. There is no annual maximum for the pediatric dental essential health benefit. When Members receiving adult dental care have met the annual maximum for Covered Services in the Schedule of Benefits section of this Contract, no more benefits will be payable for that Member for the remainder of that Plan Year. If You have other than individual coverage, the individual annual maximum for adult dental care benefits applies to each person covered under this Contract. Once a person within a family meets the individual annual maximum for adult dental care, no more benefits for services will be payable for that person.
Appears in 11 contracts
Samples: Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract
Annual Maximum. This Contract has an annual maximum for Adult Dental Care benefits described in the Adult Dental Care section of this Contract. There is no annual maximum for the pediatric dental essential health benefit. When Members receiving adult dental care have met the annual maximum for Covered Services in the Schedule of Benefits section of this Contract, no more benefits will be payable for that Member for the remainder of that Plan Year. If You have other than individual coverage, the individual annual maximum for adult dental care benefits applies to each person covered under this Contract. Once a person within a family meets the individual annual maximum for adult dental care, no more benefits for services will be payable for that person.
Appears in 9 contracts
Samples: Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract, Preferred Provider Organization Insurance Contract
Annual Maximum. This Contract has an in-network and out-of-network annual maximum for Adult Dental Care benefits described in the Adult Dental Care section of this Contract. There is no annual maximum for the pediatric dental essential health benefit. When Members receiving adult dental care have met the annual maximum for Covered Services in the Schedule of Benefits section of this Contract, no more benefits will be payable for that Member for the remainder of that Plan Year. If You have other than individual coverage, the individual annual maximum for adult dental care benefits applies to each person covered under this Contract. Once a person within a family meets the individual annual maximum for adult dental care, no more benefits for services will be payable for that person.
Appears in 2 contracts
Samples: Preferred Provider Organization Contract, Preferred Provider Organization Contract
Annual Maximum. This Contract has an in-network and out-of-network annual maximum for Adult Dental Care non-orthodontic benefits described in the Adult Dental Care section of this Contract. There is no annual maximum for the pediatric dental essential health benefit. When Members receiving adult dental care have met the annual maximum for Covered Services in the Schedule of Benefits section of this Contract, no more benefits will be payable for that Member for the remainder of that Plan Year. If You have other than individual coverage, the individual annual maximum for adult dental care benefits applies to each person covered under this Contract. Once a person within a family meets the individual annual maximum for adult dental care, no more benefits for services will be payable for that person.
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