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 a non - Network or an excluded Provider (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 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 - inclusive and are in addition to other exclusions listed and not listed in this Agreement. Unless a service i s 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: 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 3) 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 - non-Network or an excluded Provider (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 l ist list 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 i s is 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: Member Benefit Agreement

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 3) 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 - non-Network or an excluded Provider (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 l ist list 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 i s is 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: Member 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 3) 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 - non-Network or an excluded Provider (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 l ist list 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 i s is 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: Member Benefit Agreement

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