Dental Care Hospital Emergency Room Sample Clauses

Dental Care Hospital Emergency Room. Accident includes an accidental injury to your sound natural teeth. Accidental injuries are those caused by unexpected and unintentional means. We cover the hospital or emergency room services and the doctor’s services. We cover the treatment in an emergency room for an accidental injury to your sound natural teeth or any facial fractures (or both) if the injury itself is the direct cause (independent of disease or bodily injury).
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Dental Care Hospital Emergency Room. Accident includes an accidental injury to your sound natural teeth. Accidental injuries are those caused by unexpected and unintentional means. We cover the hospital or emergency room services and the doctor’s services. We cover the treatment in an emergency room for an accidental injury to your sound natural teeth or any facial fractures (or both) if the injury itself is the direct cause (independent of disease or bodily injury). The amount that you pay for a covered hospital emergency room visit differs depending on whether the service is the first, second, or subsequent hospital emergency room visit in a calendar year. See the Summary of Benefits for benefit limits and your copayment.amount.

Related to Dental Care Hospital Emergency Room

  • Dental Care Plan The Welfare Plan will include a Dental Care Plan which will reimburse members for expenses incurred in respect of the coverages summarized in Appendix "1". The Plan will not duplicate benefits provided now or which may be provided in the future by any government program.

  • Medical Emergencies If you encounter a medical emergency that makes you unable to pay your bill for a period of time, or that requires your account remain active, even if it has already been suspended or disconnected, Viasat may payment or reconnection options available for you. You must contact Viasat immediately upon learning of such emergency to determine what options are available in your situation. If you reside in Maine or Pennsylvania, please contact us regarding the specific procedures to follow for relief.

  • Child or Elder Care Emergencies Leave without pay, compensatory time or paid leave may be granted for child or elder care emergencies.

  • Medical Emergency A medical condition which manifests itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate attention to result in 1) placing the health of the individual (or with respect to a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; 2) serious impairment to bodily functions; or 3) serious dysfunction of any bodily organ or part. Examples of a medical emergency are severe pain, suspected heart attacks and fractures. Examples of a non- medical emergency are minor cuts and scrapes. Medically Necessary and Medical Necessity Services a physician, exercising prudent clinical judgment, would use with a patient to prevent, evaluate, diagnose or treat an illness or injury or its symptoms. These services must:  Agree with generally accepted standards of medical practice  Be clinically appropriate in type, frequency, extent, site and duration., They must also be considered effective for the patient’s illness, injury or disease  Not be mostly for the convenience of the patient, physician, or other healthcare provider. They do not cost more than another service or series of services that are at least as likely to produce equivalent therapeutic or diagnostic results for the diagnosis or treatment of that patient’s illness, injury or disease. For these purposes, “generally accepted standards of medical practice” means standards that are based on credible scientific evidence published in peer reviewed medical literature. This published evidence is recognized by the relevant medical community, physician specialty society recommendations and the views of physicians practicing in relevant clinical areas and any other relevant factors. Member Any person covered under this plan. Mental Condition A condition that is listed in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). This does not include conditions and treatments for chemical dependency. Mental Health Services Medically necessary outpatient and inpatient services provided to treat mental conditions. State and federal law require that the copays and coinsurance for mental health services will be no more than the copays and coinsurance for medical and surgical services. Prescription drugs for mental conditions are covered under the same terms and conditions as other prescription drugs covered under this plan.

  • Dental Care Benefits (a) The Employer shall provide such regular, full-time seniority employee (and her eligible dependents*) the 100/75/50 Co-Pay Dental Plan in effect January 1, 2014, subject to such terms, conditions, exclusions, limitations, deductibles, co-payments and other provisions of the plan. The Employer shall pay 95% of the illustrated premium cost of such benefits and the employee shall pay the balance. Coverage shall commence on the day following the employee's ninetieth (90th) day of continuous employment.

  • Vision Care Plan The County agrees to provide a Vision Care Plan for all employees and dependents. The Plan will be the Vision Service Plan - Plan A with benefits at 12/12/24 month intervals and with twenty dollar ($20.00) deductible for examinations and twenty dollar ($20.00) deductible for materials. The County will fully pay the monthly premium for the employee and dependents and pick up inflationary costs during the term of the Agreement.

  • Dependent Care Assistance Program The County offers the option of enrolling in a Dependent Care Assistance Program (DCAP) designed to qualify for tax savings under Section 129 of the Internal Revenue Code, but such savings are not guaranteed. The program allows employees to set aside up to five thousand dollars ($5,000) of annual salary (before taxes) per calendar year to pay for eligible dependent care (child and elder care) expenses. Any unused balance is forfeited and cannot be recovered by the employee.

  • Health Care Spending Account After six (6) months of permanent employment, full time and part time (20/40 or greater) employees may elect to participate in a Health Care Spending Account (HCSA) Program designed to qualify for tax savings under Section 125 of the Internal Revenue Code, but such savings are not guaranteed. The HCSA Program allows employees to set aside a predetermined amount of money from their pay, not to exceed the maximum amount authorized by federal law, per calendar year, of before tax dollars, for health care expenses not reimbursed by any other health benefit plans. HCSA dollars may be expended on any eligible medical expenses allowed by Internal Revenue Code Section 125. Any unused balance is forfeited and cannot be recovered by the employee.

  • DEPENDENT CARE REIMBURSEMENT ACCOUNT During the term of this MOU, Management agrees to maintain a Dependent Care Reimbursement Account (DCRA), qualified under Section 129 of the Internal Revenue Code, for active employees who are members of LACERS, provided that sufficient enrollment is maintained to continue to make the account available. Enrollment in the DCRA is at the discretion of each employee. All contributions into the DCRA and related administrative fees shall be paid by employees who are enrolled in the plan. As a qualified Section 129 Plan, the DCRA shall be administered according to the rules and regulations specified for such plans by the Internal Revenue Service.

  • Health Care Benefits (a) Each regular full-time employee may elect coverage for himself and his eligible dependents* under one of the following health insurance plans:

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