ELIGIBLE MEDICAL EXPENSES Sample Clauses

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.
Sample 1
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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...
Sample 1
ELIGIBLE MEDICAL EXPENSES. Medical expenses for medical treatment required because of athletic related injuries and provided or prescribed by a legally qualified physician,paraprofessional or hospital, provided the medical expense is incurred within 104 weeks after the date of injury. Protective devices, equipment, or clothing used solely during practice or competition and for the purpose of preventing further injury or aggravation to an existing injury, are not covered under this policy. Expense for travel, other than by a professional ambulance service, is not covered. NMU is not responsible for medical payments related to a pre-existing injury or condition or complications associated with a pre-existing injury or condition. General medical conditions that result from direct participation in varsity athletic activity (eg: swimmers ear) Orthotics/Orthotic evaluation Vision injury that occurs as a direct result of participation in organized varsity athletic activity (practice, game, conditioning, weight training) General injury/illness not relations to participation in athletics (includes injections such as immunizations, allergy/flu shots) Chiropractic evaluation/care General injury/illness that occurs in athletic activity outside of organized varsity athletic activity (intramurals, club sports) Pre-existing Injury/Condition and complications of such.
Sample 1
ELIGIBLE MEDICAL EXPENSES 
Sample 1

Related to ELIGIBLE MEDICAL EXPENSES

  • Medical Expenses 1. Employees exposed to hazardous physical, biological, or chemical agents shall be provided, at no cost to the employee, with medical examinations or evaluations required by VOSHA regulations. If there are no specific VOSHA regulations or standards for the agent in question, recommendations of the National Institute of Occupational Safety and Health or other generally recognized expert organization shall be used, as determined by the Commissioner of Health. 2. Employees determined by the Health Department to be at substantial risk for exposure to contagious diseases shall be provided appropriate vaccines. Groups at risk will be defined by the Vermont Department of Health. If no guidelines have been published by the Department of Health, the guidelines published by the Center for Disease Control in Atlanta, Georgia will apply. Vaccines and/or appropriate medical examinations will be provided at no cost to the employee according to applicable guidelines. 3. Any Department wishing to implement a Medical Monitoring Program on or after July 1, 1990, shall do so by conferring with the Health Department, and the Department of Human Resources. Prior to implementation, the Department of Human Resources shall notify VSEA. The parties shall meet within ten (10) days (unless mutually extended) after a request for negotiations by either party and thereafter on a regular basis for a period not exceeding forty-five (45) calendar days, after which the State may implement the program, whether or not the parties have bargained to genuine impasse. The VSEA shall retain all statutory impasse procedure rights as may be lawfully available to VSEA during the life of this Agreement, provided, however, the State at any time may withdraw its proposed medical monitoring program or terminate without further bargaining a medical monitoring program previously implemented, in which case, such retained statutory impasse procedure rights are extinguished.

  • FUNERAL EXPENSES The City shall expend a sum not to exceed $30,000 for funeral expenses to the heirs of any employee covered by this MOU who dies while on active duty from injuries incurred while performing his/her job or who dies as a direct cause of such injuries. This amount includes the amount already available for this purpose in accordance with California State Labor Code Section 4701.

  • Medical/Dental Expense Account The Employer agrees to allow insurance eligible employees to participate in a medical and dental expense reimbursement program to cover co- payments, deductibles and other medical and dental expenses or expenses for services not covered by health or dental insurance on a pre-tax basis as permitted by law or regulation, up to the maximum amount of salary reduction contributions allowed per calendar year under Section 125 of the Internal Revenue Code or other applicable federal law.

  • Unreimbursed medical expenses If you take payments to pay for unreimbursed medical expenses that exceed a specified percentage of your adjusted gross income, you will not be subject to the 10 percent early distribution penalty tax. For further detailed information and effective dates you may obtain IRS Publication 590-B, Distributions from Individual Retirement Arrangements (IRAs), from the IRS. The medical expenses may be for you, your spouse, or any dependent listed on your tax return.

  • Professional Expenses Each calendar year during the Employment Term, the Company agrees to reimburse the Executive for up to $10,000 of reasonable professional expenses (i.e., accounting, financial planning, estate planning expenses) incurred by the Executive during such year for personal advice rendered to the Executive.

  • 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.

  • Payment of Extraordinary Education Related Expenses Section 5.1. PAYMENT OF EXTRAORDINARY EDUCATION-RELATED EXPENSES. In addition to the amounts determined pursuant to Articles IV and VI of this Agreement, Applicant on an annual basis shall also indemnify and reimburse District for all non-reimbursed costs, certified by the District’s external auditor to have been incurred by the District for extraordinary education-related expenses directly and solely related to the project that are not directly funded in state aid formulas, including expenses for the purchase of portable classrooms and the hiring of additional personnel to accommodate a temporary increase in student enrollment caused directly by such project. Applicant shall have the right to contest the findings of the District’s external auditor pursuant to Section 4.9 above.

  • Legal Expenses Each Credit Party 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.

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