Common use of COVERED SERVICES OR SUPPLIES Clause in Contracts

COVERED SERVICES OR SUPPLIES. The types of services and supplies described in the Covered Services and Supplies section of this Contract. Read the entire Contract to find out what We limit or exclude. CREDITABLE COVERAGE. Coverage under any of the following: a Group Health Plan; a group or individual Health Benefits Plan; Part A or Part B of Title XVIII of the federal Social Security Act (Medicare); Title XIX of the federal Social Security Act (Medicaid), other than coverage consisting solely of benefits under section 1928 of Title XIX of the federal Social Security Act (the program for distribution of pediatric vaccines); chapter 55 of Title 10, United States Code (medical and dental care for members and certain former members of the uniformed services and their dependents); a medical care program of the Indian Health Service or of a tribal organization; a state health benefits risk pool; a health plan offered under chapter 89 of Title 5, United States Code; a Public Health Plan as defined by federal regulation (Please refer to the definition of Public Health Plan in this Contract and note the different meaning of the term with respect to a Federally Defined Eligible Individual and a person who is not a Federally Defined Eligible Individual); a health benefits plan under section 5(e) of the “Peace Corps Act”; Title XXI of the federal Social Security Act (State Children’s Health Insurance Program), or coverage under any other type of plan as set forth by the Commissioner of Banking and Insurance by regulation. Creditable Coverage does not include coverage which consists solely of the following: coverage only for accident or disability income insurance, or any combination thereof; coverage issued as a supplement to liability insurance; liability insurance, including general liability insurance and automobile liability insurance; workers’ compensation or similar insurance; automobile medical payment insurance; credit only insurance; coverage for on-site medical clinics; coverage as specified in federal regulation, under which benefits for medical care are secondary or incidental to the insurance benefits; and other coverage expressly excluded from the definition of Health Benefits Plan. CURRENT PROCEDURAL TERMINOLOGY (C.P.T.) The most recent edition of an annually revised listing published by the American Medical Association which assigns numerical codes to procedures and categories of medical care.

Appears in 5 contracts

Samples: Hmo Contract, Hmo Health Benefits Contract, Hmo Contract

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