Common use of EXCLUSIONS FROM BENEFITS Clause in Contracts

EXCLUSIONS FROM BENEFITS. The Plan will not provide Benefits for: (1) anything that is not Medically Necessary; (2) anything provided before or after the dates coverage is effective (except as required by law); (3) non-Covered Services and any services, items, or charges related to non-Covered Services; (4) services, supplies, and any charges from an excluded Provider; (5) items and services furnished outside the United States; and (6) services and supplies to the extent that you do not have to pay or you have the right to recover expenses through a federal, state, county, or local law (even if you waive or do not assert your rights). The following list of services and supplies specifies not Covered Services and the Plan will not provide Benefits for them. These listed exclusions are not all-inclusive and are in addition to other exclusions listed and not listed in this Agreement. Unless a service is listed as a covered benefit in Section 4, it is likely not covered. If you pay for a non-Covered Service, it will not count toward your Out-of-Pocket Cost limits.

Appears in 3 contracts

Samples: Member Benefit Agreement, Member Benefit Agreement, Member Benefit Agreement

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EXCLUSIONS FROM BENEFITS. β€Œ The Plan will not provide Benefits for: (1) anything that is not Medically Necessary; (2) anything provided before or after the dates coverage is effective (except as required by law); (3) non-Covered Services and any services, items, or charges related to non-Covered Services; (4) services, supplies, and any charges from an excluded Provider; (5) items and services furnished outside the United States; and (6) services and supplies to the extent that you do not have to pay or you have the right to recover expenses through a federal, state, county, or local law (even if you waive or do not assert your rights). The following list of services and supplies specifies not Covered Services and the Plan will not provide Benefits for them. These listed exclusions are not all-inclusive and are in addition to other exclusions listed and not listed in this Agreement. Unless a service is listed as a covered benefit in Section 4, it is likely not covered. If you pay for a non-Covered Service, it will not count toward your Out-of-Pocket Cost limits.. [

Appears in 1 contract

Samples: Member Benefit Agreement

EXCLUSIONS FROM BENEFITS. The Plan will not provide Benefits for: (1) anything that is not Medically Necessary; (2) anything provided before or after the dates coverage is effective (except as required by law); (33 ) non-non- Covered Services and any services, items, or charges related to non-non - Covered Services; (4) services, supplies, and any charges from a non - Network or an excluded ProviderProvider (unless specified as Covered under section 4.B) ; (5) items and services furnished outside the United States; and (6) services and supplies to the extent that you do not have to pay or you have the right to recover expenses through a federal, state, county, or local law (even if you waive or do not assert your rights). The following list l ist of services and supplies specifies not Covered Services and the Plan will not provide Benefits for them. These listed exclusions are not all-all - inclusive and are in addition to other exclusions listed and not listed in this Agreement. Unless a service is i s listed as a covered benefit in Section 4, it is likely not covered. If you pay for a non-non - Covered Service, it will not count toward your Out-of-Out - of- Pocket Cost limits.

Appears in 1 contract

Samples: Benefit Agreement

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EXCLUSIONS FROM BENEFITS. The Plan will not provide Benefits for: (1) anything that is not Medically Necessary; (2) anything provided before or after the dates coverage is effective (except as required by law); (3) non-Covered Services and any services, items, or charges related to non-non- Covered Services; (4) services, supplies, and any charges from an excluded Provider; (5) items and services furnished outside the United States; and (6) services and supplies to the extent that you do not have to pay or you have the right to recover expenses through a federal, state, county, or local law (even if you waive or do not assert your rights). The following list of services and supplies specifies not Covered Services and the Plan will not provide Benefits for them. These listed exclusions are not all-inclusive and are in addition to other exclusions listed and not listed in this Agreement. Unless a service is listed as a covered benefit in Section 4, it is likely not covered. If you pay for a non-Covered Service, it will not count toward your Out-of-Pocket Cost limits.

Appears in 1 contract

Samples: Member Benefit Agreement

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