Common use of EXCLUSION FOR DUPLICATE COVERAGE Clause in Contracts

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Security Act (commonly known as "Medi- care"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graph. 3. Benefits to which the Subscriber is entitled un- der any workers' compensation or employers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Injury which was the basis of the Sub- xxxxxxx'x claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployer, labor union, corporation or association, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness Sick- ness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided Ser- vices provided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersemploy- ers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation or associationassocia- tion, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided provid- ed without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury Inju- ry as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Security Act (commonly known as "Medi- care"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graph. 3. Benefits to which the Subscriber is entitled un- der any workers' compensation or employers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Injury which was the basis of the Sub- xxxxxxx'x claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployer, labor union, corporation corporation, or association, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided provided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided provided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices Services under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation or association, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided provided without any liability for the cost thereof, for the treatment of that same Sickness Sick- ness or Accidental Injury as a result of the Subscriber's Sub- xxxxxxx'x entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersemploy- ers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation or associationassocia- tion, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness Sick- ness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided Ser- vices provided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersemploy- ers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation corporation, or associationasso- ciation, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness Sick- ness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided Ser- vices provided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state State governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersemploy- ers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation corporation, or associationassoci- ation, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided provid- ed without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury Inju- ry as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided provided to the Subscriber by any federal or state governmental agency, or by any municipalitymunic- ipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Califor- nia Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersem- ployers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation corporation, or associationasso- ciation, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or or, the reasonable reasona- ble value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided provided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided provided to the Subscriber by any federal or state governmental agency, or by any municipalitymunic- ipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Califor- nia Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code Code, are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersem- ployers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices Services under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation corporation, or association, or under un- der any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.BIV>B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided provided without any liability for the cost thereof, for the treatment of that same Sickness Sick- ness or Accidental Injury as a result of the Subscriber's Sub- xxxxxxx'x entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersemploy- ers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation or associationassocia- tion, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided provided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided provided to the Subscriber by any federal or state governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices Services under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation or association, or under any individual policy or health service plan agreement.

EXCLUSION FOR DUPLICATE COVERAGE. In the event that an individual is both enrolled as a Subscriber under this Agreement and entitled to benefits under any of the conditions described in paragraphs 1. through 4. of this section IV.B, Blue Shield's liability for Services provided to the Sub- xxxxxxx Subscriber for the treatment of any one (1) Sickness Sick- ness or Accidental Injury shall be reduced by the amount of benefits paid, or the reasonable value or the amount payable to the provider under the Medicare Program, whichever is less, of the Services pro- vided Ser- vices provided without any liability for the cost thereof, for the treatment of that same Sickness or Accidental Injury as a result of the Subscriber's entitlement to such other benefits. This exclusion is applicable to: 1. Benefits provided under Title XVIII of the So- cial Social Security Act (commonly known as "Medi- careMedicare"). 2. Any Services, including room and board, pro- vided to the Subscriber by any federal or state State governmental agency, or by any municipality, county, or other political subdivision, except that benefits provided under Chapters 7 and 8 of Part 3, Division 9 of the California Welfare and Institution Code (commonly known as Medi-Cal) or Subchapter 19 (commencing with Section 1396) of Chapter 7 of Title 42 of the United States Code are not subject to this para- graphparagraph. 3. Benefits to which the Subscriber is entitled un- der under any workers' compensation or employersemploy- ers' liability law, provided however that Blue Shield's rights under this paragraph will be lim- ited limited to the establishment of a lien upon such other benefits up to the amount paid by Blue Shield for the treatment of the Sickness or Ac- cidental Accidental Injury which was the basis of the Sub- xxxxxxx'x Subscriber's claim for benefits under such workers' compensation or employers' liability law. 4. Benefits provided to the Subscriber for Ser- vices under any group insurance contract or health service plan agreement through any em- ployeremployer, labor union, corporation corporation, or associationasso- ciation, or under any individual policy or health service plan agreement.