ELIGIBLE MEDICAL EXPENSES Sample Clauses

ELIGIBLE MEDICAL EXPENSES. The Policy covers the following eligible services and supplies provided to you or your covered family members. However, the Policy covers only those services and supplies which were medically necessary and only up to reasonable and customary charges, subject to additional restrictions and limitations set forth below and in the Policy: COVERED SERVICES LIMITATIONS AND RESTRICTIONS Acupuncture In lieu of anesthesia only Ambulance Transportation To and from the nearest facility that can give necessary treatment Ambulatory Surgery Pre-Certification required Anesthesia Assistant Surgeon Benefits not payable for hospitals where surgical assistant is routinely available Birthing Center Benefits not to exceed those otherwise available for pregnancy under the Policy Blood or Blood Plasma Must not be replaced on behalf of the eligible person Cardiac Rehabilitation Pre-Certification required Services Chiropractic Care Pre-Certification required; CHI pays up to a maximum benefit amount of $1,000 per calendar year for detection and correction by manual means of structural imbalance or o subluxation resulting from or related to distortion, misalignment or subluxation of or in the vertical column Consultation Only for consultation requested by the attending physician and given while confined as an in-patient Diagnostic Services Durable Medical Equipment Pre-Certification required on items leased or purchased for more than $1,500 Emergency Services Notification must be made within 24 hours of any admission or as soon thereafter as reasonably possible; Emergency services must be received within 48 hours after the onset of the medical emergency Hemodialysis Home Health Services Pre-Certification required One visit per day; up to 4 hours constitute 1 home health care visit; Hospice Care Pre-Certification required; Maximum individual lifetime benefit of $10,000; Attending physician must certify that the covered person is terminally ill and must recommend admission into a hospice care program Hospital Outpatient Care: Pre-Certification required Inpatient Care: Pre-Certification required (Room & Board at Semi-Private Room Rate*) *Unless Private Room is Medically Necessary Immunization for No deductible and no co-insurance; Children Limited to minimum benefits mandated by the Department of Insurance Infertility Services to diagnose infertility only; Does not cover infertility treatment Inpatient Physician While confined as an inpatient in a hospital Services or skilled nursing f...
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ELIGIBLE MEDICAL EXPENSES. The phrase “Eligible Healthcare Expense” means any expense incurred by a Participant or any of his Dependents during a Plan Year that (i) qualifies as a medical care expense under Code Section 213 and/or Revenue Ruling 2003- 102 and meets the requirements outlined in Section 125 and its regulations, (ii) is excluded from gross income of the Participant under Code Section 10 (b), and (iii) has not been, and will not be paid or reimbursed by any other insurance plan, though damages, from any other source, provided, however, that no medical care expense shall be reimbursed unless the treatment giving rise to the expense is prescribed by a licensed practitioner of the healing arts in the State in which the treatment is provided. In addition, a medical care expense incurred by a Participant or the Participant’s Dependent(s) prior to the date such Participant commenced participation in the Medical Reimbursement Plan shall not constitute an Eligible Medical Expense. SECTION IX HIPAA PROVISIONS FOR HEALTH FSA
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ELIGIBLE MEDICAL EXPENSES 
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Related to ELIGIBLE MEDICAL EXPENSES

  • Reimbursement of Travel Expenses If the Servicer provides access to the Review Materials at one of its properties, the Issuer will reimburse the Asset Representations Reviewer for its reasonable travel expenses incurred in connection with the Review on receipt of a detailed invoice.

  • General Expenses You authorize the Manager to charge your account with your Underwriting Percentage of all expenses of a general nature incurred by the Manager and Co-Managers under the applicable AAU in connection with the Offering, including the negotiation and preparation thereof, or in connection with the purchase, carrying, marketing and sale of any securities under the applicable AAU and any Intersyndicate Agreement, including, without limitation, legal fees and expenses, transfer taxes, costs associated with approval of the Offering by the NASD and the costs of currency transactions (including forward and hedging currency transactions) entered into to facilitate settlement of the purchase of Securities permitted under Section 3.1 hereof.

  • Legal Expenses The Borrower hereby agrees to pay all reasonable fees and expenses of special counsel to the Administrative Agent incurred by the Administrative Agent in connection with the preparation, negotiation and execution of this Amendment and all related documents.

  • Travel Expenses CONTRACTOR shall not be allowed or paid travel expenses unless set forth in this Agreement.

  • Business Expenses and Final Compensation You acknowledge that you have been reimbursed by the Company for all business expenses incurred in conjunction with the performance of your employment and that no other reimbursements are owed to you. You further acknowledge that you have received payment in full for all services rendered in conjunction with your employment by the Company, including payment for all wages, bonuses and accrued, unused vacation time, and that no other compensation is owed to you except as provided herein.

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