Community Provider Sample Clauses

Community Provider. Not covered, except in the presence of a non-related Medical Condition affecting the lower limbs. Pre-Existing Condition Covered with no wait. Preventive Services (well adult and well child physicals, immunizations, pap smears, mammograms and prostate/colorectal cancer screening) MHCN: Covered in full when in accordance with the well care schedule established by GHO. Not subject to the annual Deductible or any applicable Plan Coinsurance. Eye refractions are not included under preventive care. Physicals for travel, employment, insurance or license are not covered. Services provided during a preventive care visit which are not in accordance with the well care schedule are covered subject to the lesser of the MHCN’s charge or any applicable outpatient services Cost Share. Community Provider: Not covered, except for routine mammography services which are covered at the Plan Coinsurance, after the annual Deductible is satisfied. Rehabilitation Services • Inpatient physical, occupational and restorative speech therapy services combined, including services for neurodevelopmentally disabled children age six (6) and under MHCN and Community Provider benefit limits are combined and cannot be duplicated. MHCN: Covered subject to the lesser of the MHCN’s charge or the applicable inpatient services Copayment and at the Plan Coinsurance for up to sixty (60) days per calendar year after the annual Deductible is satisfied. Community Provider: Covered subject to the lesser of the allowed charge or the applicable inpatient services Copayment and at the Plan Coinsurance for up to sixty (60) days per calendar year after the annual Deductible is satisfied. Preauthorization is required (see Section IV.G.). • Outpatient physical, occupational and restorative speech therapy services combined, including services for neurodevelopmentally disabled children age six (6) and under MHCN and Community Provider benefit limits are combined and cannot be duplicated. MHCN: Covered subject to the lesser of the MHCN’s charge or the applicable outpatient services Copayment and at the Plan Coinsurance for up to sixty (60) visits per calendar year after the annual Deductible is satisfied. Community Provider: Covered subject to the lesser of the allowed charge or the applicable outpatient services Copayment and at the Plan Coinsurance for up to sixty (60) visits per calendar year after the annual Deductible is satisfied. Sexual Dysfunction Services MHCN: Not covered. Community Provider: Not cover...
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Community Provider. After the annual Deductible is satisfied, Members shall be required to pay the Plan Coinsurance for Covered Services as set forth in the Allowances Schedule. A benefit-specific coinsurance may apply to some Covered Services, as set forth in the Allowances Schedule. Services that are subject to the benefit-specific coinsurance are not subject to the Plan Coinsurance.
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Community Provider. Community provider" means a governmental or nongovernmental entity that provides services to students or families, including but not limited to temporary and permanent housing, case management, immigration and language services and social, behavioral health, occupational training and legal services. [PL 2021, c. 445, §2 (NEW).]
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Community Provider. Covered Services received from a Community Provider are subject to the annual Deductible as set forth in the Allowances Schedule. Charges subject to the annual Deductible shall be borne by the Subscriber during each calendar year until the annual Deductible is met. There is an individual annual Deductible amount for each Member and a maximum aggregate annual Deductible amount for each Family Unit. Once the aggregate 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.
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Community Provider. Not covered.
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Community Provider. Covered subject to the lesser of the allowed charge or the applicable Copayment and at the Plan Coinsurance up to a $350,000 lifetime benefit maximum (including organ acquisition, matching and donor costs up to $50,000) after the annual Deductible is satisfied, subject to a six (6) month benefit wait period. Plastic and Reconstructive Services (plastic surgery, cosmetic surgery) • Surgery to correct a congenital disease or anomaly, or conditions following an injury or resulting from surgery MHCN: Covered subject to the lesser of the MHCN’s charge or the applicable Copayment and at the Plan Coinsurance after the annual Deductible is satisfied. Community Provider: Covered subject to the lesser of the allowed charge or the applicable Copayment and at the Plan Coinsurance after the annual Deductible is satisfied. • Cosmetic surgery, including complications resulting from cosmetic surgery MHCN: Not covered.
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Related to Community Provider

  • Management; Community Policies Owner may retain employees and management agents from time to time to manage the Property, and Owner’s agent may retain other employees or contractors. Resident, on behalf of himself or herself and his or her Guests, agrees to comply fully with all directions from Owner and its employees and agents, and the rules and regulations (including all amendments and additions thereto, except those that substantially modify the Resident’s bargain and to which Resident timely objects) as contained in this Agreement and the Community Policies of the Property. The Community Policies are available at xxxxx://xxxxxxxxxxxxxx.xxx/policies.pdf or on request from the management office and are considered part of this Agreement.

  • Community Involvement The Grantee will facilitate and convene a Community Task Force as one means of developing collaboration among the Grantee, affected residents, and the broader community. The Grantee also will provide information to keep the Community Task Force fully apprised of the planning and implementation of revitalization efforts. The Community Task Force shall be comprised of affected public housing residents, local government officials, service providers, community groups, and others. The Community Task Force will provide advice, counsel and recommendations to the Grantee on all aspects of the HOPE VI development process, including shaping the goals and outcome of the Community and Supportive Services Plan. Community Task Force participants also will disseminate information throughout the community about the Grantee's revitalization efforts. The Grantee's responsibilities with regard to the Community Task Force include:

  • Community Relations Chancellor shall establish and maintain an appropriate community relations program. Chancellor shall attend important college and community events, develop relationships with other key public and private agencies in each of the District's relevant communities where colleges are located and be significantly involved in the District's relevant local communities.

  • Community Service Service to the wider community includes active participation in a wide variety of governmental, societal and community institutions, programs and services, where such participation is based on the candidate’s academic or professional expertise.

  • Citizen Volunteer or Community Service Leave Leave without pay may be granted for community volunteerism or service.

  • Community Partnerships The Contractor must submit a Communication Plan (“Plan”) developed with each Housing Assessment and Resource Agency (“HARA”) within their assigned Region(s):

  • Covered Health Care Services We agree to provide coverage for medically necessary covered health care services listed in this agreement. If a service or category of service is not specifically listed as covered, it is not covered under this agreement. Only services that we have reviewed and determined are eligible for coverage under this agreement are covered. All other services are not covered. See Section 1.4 for how we identify new services and our guidelines for reviewing and making coverage determinations. We only cover a service listed in this agreement if it is medically necessary. We review medical necessity in accordance with our medical policies and related guidelines. The term medically necessary is defined in Section 8.0 - Glossary. It does not include all medically appropriate services. The amount of coverage we provide for each health care service differs according to whether or not the service is received:  as an inpatient;  as an outpatient ;  in your home;  in a doctor’s office; or  from a pharmacy. Also coverage differs depending on whether:  the health care provider is a network provider or non-network provider;  deductibles (if any), copayments, or maximum benefit apply;  you have reached your plan year maximum out-of-pocket expense;  there are any exclusions from coverage that apply; or  our allowance for a covered health care service is less than the amount of your copayment and deductible (if any). In this case, you will be responsible to pay up to our allowance when services are rendered by a network provider. Please see the Summary of Medical Benefits to determine the benefit limits and amount that you pay for the covered health care services listed below. Please see the Summary of Pharmacy Benefits to determine the benefit limits and amount that you pay for prescription drug and diabetic equipment and supplies purchased at a pharmacy.

  • Special Rules Regarding Related Entities and Branches That Are Nonparticipating Financial Institutions If a Finnish Financial Institution, that otherwise meets the requirements described in paragraph 1 of this Article or is described in paragraph 3 or 4 of this Article, has a Related Entity or branch that operates in a jurisdiction that prevents such Related Entity or branch from fulfilling the requirements of a participating FFI or deemed-compliant FFI for purposes of section 1471 of the U.S. Internal Revenue Code or has a Related Entity or branch that is treated as a Nonparticipating Financial Institution solely due to the expiration of the transitional rule for limited FFIs and limited branches under relevant U.S. Treasury Regulations, such Finnish Financial Institution shall continue to be in compliance with the terms of this Agreement and shall continue to be treated as a deemed- compliant FFI or exempt beneficial owner, as appropriate, for purposes of section 1471 of the U.S. Internal Revenue Code, provided that:

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