Covered Service. a service or supply specified in the Agreement and summarized in Section CS - Description Of Covered Services for which benefits will be provided. CUSTODIAL CARE (DOMICILIARY CARE) – care provided primarily for maintenance of the patient or care which is designed essentially to assist the patient in meeting his activities of daily living and which is not primarily provided for its therapeutic value in the treatment of an illness, disease, bodily injury, or condition. Custodial Care includes, but is not limited to, help in walking, bathing, dressing, feeding, preparation of special diets and supervision of self-administration of medications which do not require the technical skills or professional training of medical or nursing personnel in order to be performed safely and effectively. DEDUCTIBLE – The amount of the Allowable Amount that must be incurred by a Member each Agreement Year before benefits are covered under this Subscriber Agreement. Deductibles, if any, are identified in Section SC - Schedule Of Cost Sharing. DEPENDENT –
Appears in 8 contracts
Samples: Individual Hmo Subscriber Agreement, Hmo Subscriber Agreement, Hmo Subscriber Agreement
