Home Healthcare Services Sample Clauses

Home Healthcare Services. Covered Services include services given to a Member in his home by a licensed Home Healthcare Provider or an approved Hospital program for Home Healthcare. Such services are covered when:  such care is given in place of Inpatient Hospital or Skilled Nursing Facility care and/or;  the Member is not physically able to obtain Medically Necessary care on an outpatient basis; and/or  the Member is under the care of a Physician; and/or  the Member is homebound for medical reasons. NOTE: The Member is responsible for one cost-share per day per Home Healthcare agency. Covered Services and supplies provided by a Home Healthcare agency include:  Professional services of a registered nurse, licensed practical nurse or a licensed vocational nurse on an intermittent basis.  Physical therapy, speech therapy and occupational therapy by a licensed therapist.  Medical and surgical supplies that are customarily furnished by the Home Healthcare agency or program for its patients.  Prescribed drugs furnished and charged for by the Home Healthcare agency or program. Prescribed drugs under this provision do not include Specialty Prescription Drugs.  One (1) medical social service consultation per course of treatment.  One (1) nutrition consultation by a certified registered dietitian.  Health aide services furnished to Member only when receiving nursing services or therapy.
Sample 1Sample 2Sample 3
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Home Healthcare Services. Covered Services include services given to a Member in his home by a licensed Home Healthcare Provider or an approved Hospital program for Home Healthcare. Such services are covered when a Member is homebound for medical reasons, physically not able to obtain Medically Necessary care on an outpatient basis, under the care of a Physician and such care is given in place of Inpatient Hospital or Skilled Nursing Facility care. Covered Services and supplies provided by a Home Healthcare agency include:  Professional services of a registered nurse, licensed practical nurse or a licensed vocational nurse on an intermittent basis.  Physical therapy, speech therapy and occupational therapy by a licensed therapist.  Medical and surgical supplies that are customarily furnished by the Home Healthcare agency or program for its patients.  Prescribed drugs furnished and charged for by the Home Healthcare agency or program. Prescribed drugs under this provision do not include Specialty Prescription Drugs. Please refer to the optional HPN Prescription Drug Benefit Rider, if applicable to your Plan, for information on benefits available for Specialty covered drugs.  One (1) medical social service consultation per course of treatment.  One (1) nutrition consultation by a certified registered dietitian.
Sample 1Sample 2Sample 3
Home Healthcare Services. Covered Services include services given to a Member in his home by a licensed Home Healthcare Provider or an approved Hospital program for Home Healthcare. Such services are covered when a Member is homebound for medical reasons, physically not able to obtain Medically Necessary care on an outpatient basis, under the care of a Physician and such care is given in place of Inpatient Hospital or Skilled Nursing Facility care. Covered Services and supplies provided by a Home Healthcare agency include: • Professional services of a registered nurse, licensed practical nurse or a licensed vocational nurse on an intermittent basis. • Physical therapy, speech therapy and occupational therapy by a licensed therapist. • Medical and surgical supplies that are customarily furnished by the Home Healthcare agency or program for its patients. • Prescribed drugs furnished and charged for by the Home Healthcare agency or program. Prescribed drugs under this provision do not include Specialty Prescription Drugs. Please refer to the optional HPN Prescription Drug Benefit Rider, if applicable to your Plan, for information on benefits available for Specialty covered drugs. (1) medical social service consultation per course of treatment. • One (1) nutrition consultation by a certified registered dietitian. • Health aide services furnished to Member only when receiving nursing services or therapy.
Sample 1Sample 2
Home Healthcare Services. Covered Services include services given to an Insured in his home by a licensed Home Healthcare Provider or an approved Hospital program for Home Healthcare. Such services are covered when:  such care is given in place of Inpatient Hospital or Skilled Nursing Facility care and/or;  the Insured is not physically able to obtain Medically Necessary care on an outpatient basis; and/or  the Insured is under the care of a Physician; and/or  the Insured is homebound for medical reasons. NOTE: The Insured is responsible for one cost-share per day per Home Healthcare agency. Covered Services and supplies provided by a Home Healthcare agency include:  Professional services of a registered nurse, licensed practical nurse or a licensed vocational nurse on an intermittent basis.  Physical therapy, speech therapy and occupational therapy by a licensed therapist.  Medical and surgical supplies that are customarily furnished by the Home Healthcare agency or program for its patients.  Prescribed drugs furnished and charged for by the Home Healthcare agency or program. Prescribed drugs under this provision do not include Specialty Prescription Drugs. Please refer to the optional SHL Prescription Drug Benefit Rider, if applicable to your Plan, for information on benefits available for Specialty covered drugs.  One (1) medical social service consultation per course of treatment.  One (1) nutrition consultation by a certified registered dietitian.  Health aide services furnished to Insured only when receiving nursing services or therapy.
Sample 1Sample 2
Home Healthcare Services. Covered Services include services given to a Member in his home by a licensed Home Healthcare Provider or an approved Hospital program for Home Healthcare. Such services are covered when: • such care is given in place of Inpatient Hospital or Skilled Nursing Facility care and/or; • the Member is not physically able to obtain Medically Necessary care on an outpatient basis; and/or • the Member is under the care of a Physician; and/or • the Member is homebound for medical reasons. NOTE: The Member is responsible for one cost-share per day per Home Healthcare agency. Covered Services and supplies provided by a Home Healthcare agency include: • Professional services of a registered nurse, licensed practical nurse or a licensed vocational nurse on an intermittent basis. • Physical therapy, speech therapy and occupational therapy by a licensed therapist. • Medical and surgical supplies that are customarily furnished by the Home Healthcare agency or program for its patients. • Prescribed drugs furnished and charged for by the Home Healthcare agency or program. Prescribed drugs under this provision do not include Specialty Prescription Drugs. Please refer to the optional HPN Prescription Drug Benefit Rider, if applicable to your Plan, for information on benefits available for Specialty covered drugs. • One (1) medical social service consultation per course of treatment. • One (1) nutrition consultation by a certified registered dietitian. • Health aide services furnished to Member only when receiving nursing services or therapy.
Sample 1
Home Healthcare Services. Covered Services include services given to a Member in his home by a licensed Home Healthcare Provider or an approved Hospital program for Home Healthcare. Such services are covered when a Member is homebound for medical reasons, physically not able to obtain Medically Necessary care on an outpatient basis, under the care of a Physician and such care is given in place of Inpatient Hospital or Skilled Nursing Facility care. Covered Services and supplies provided by a Home Healthcare agency include:  Professional services of a registered nurse, licensed practical nurse or a licensed vocational nurse on an intermittent basis.  Physical therapy, speech therapy and occupational therapy by a licensed therapist.  Medical and surgical supplies that are customarily furnished by the Home Healthcare agency or program for its patients.  Prescribed drugs furnished and charged for by the Home Healthcare agency or program. Prescribed drugs under this provision do not include Specialty Prescription Drugs. (1) medical social service consultation per course of treatment.  One (1) nutrition consultation by a certified registered dietitian.  Health aide services furnished to Member only when receiving nursing services or therapy.
Sample 1
Home Healthcare Services. Covered Services include services given to an Insured in his home by a licensed Home Healthcare Provider or an approved Hospital programfor Home Healthcare. Such services are covered when: • such care is given in place of Inpatient Hospital or Skilled Nursing Facility care and/or; • the Insured is not physically able to obtain Medically Necessary care on an outpatient basis; and/or • the Insured is under the care of a Physician; and/or • the Insured is homebound for medical reasons.
Sample 1
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Related to Home Healthcare Services

  • COVERED HEALTHCARE SERVICES This section describes covered healthcare services. This plan covers services only if they meet all of the following requirements: • Listed as a covered healthcare service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered healthcare service under this plan. • Medically necessary, consistent with our medical policies and related guidelines at the time the services are provided. • Not listed in Exclusions Section. • Received while a member is enrolled in the plan. • Consistent with applicable state or federal law. We review medical necessity in accordance with our medical policies and related guidelines. Our medical policies can be found on our website. Our medical policies are written to help administer benefits for the purpose of claims payment. They are made available to you for informational purposes and are subject to change. Medical policies are not meant to be used as a guide for your medical treatment. Your medical treatment remains a decision made by you with your physician. If you have questions about our medical policies, please call Customer Service. When a new service or drug becomes available, when possible, we will review it within six (6) months of one of the events described below to determine whether the new service or drug will be covered: • the assignment of an American Medical Association (AMA) Current Procedural Terminology (CPT) code in the annual CPT publication; • final Food and Drug Administration (FDA) approval; • the assignment of processing codes other than CPT codes or approval by governing or regulatory bodies other than the FDA; • submission to us of a claim meeting the criteria above; and • generally, the first date an FDA approved prescription drug is available in pharmacies (for prescription drug coverage only). During the review period, new services and drugs are not covered. For all covered healthcare services, please see the Summary of Medical Benefits and the Summary of Pharmacy Benefits to determine the amount that you pay and any benefit limits.

  • Vision Care Services For purposes of coordination of benefits, vision care services covered under other plans are not considered an allowable expense, as defined in the Coordination of Benefits and Subrogation in Section 7.

  • Hospice Services Services are available for a Member whose Attending Physician has determined the Member's illness will result in a remaining life span of six months or less.

  • Core Services The Company agrees to provide to the Municipality the Core Services set forth in Schedule “A”. The Company and the Municipality may amend Schedule “A” from time to time upon mutual agreement.

  • Financial Services Article 116

  • Educational Services Any service or supply for education, training or retraining services or testing including: special education, remedial education; cognitive remediation; wilderness/outdoor treatment, therapy or adventure programs (whether or not the program is part of a Residential Treatment facility or otherwise licensed institution); job training or job hardening programs; educational services and schooling or any such related or similar program including therapeutic programs within a school setting.

  • Software Services If elected by Customer, the following Software Services will be made available for Customer’s use. 2.1. Core HR Software Service is a system of interactive web pages to assist Customer in its human resource related recordkeeping and reporting. Customer shall ensure the accuracy of its Customer Data. The HR Software Services shall function in accordance with the Documentation, as may be amended from time to time, and provide features to aid Customer with its compliance with federal and state laws and regulations applicable to Human Resources (except as stated otherwise in the Documentation). 2.2. Recruiting Software Service is a system of interactive web pages to assist Customer in posting job requisitions, storing candidates, recording job applications, and the related recordkeeping and reporting. Customer shall ensure the accuracy of its Customer Data. The Recruiting Software Service shall function in accordance with the Documentation which may be amended from time to time.

  • Healthcare Section 1. Bargaining unit employees with one (1) year or more of service will be provided coverage for the duration of this contract through the “Full Coverage” Team Care Plan (“Team Care MM200”), which includes dental, vision, life, short term disability, medical and prescription drug benefits. Prior to January 1, 2020, bargaining unit employees with less than one (1) year of service will be provided coverage through the “Medical Only” plan. On January 1, 2020, all bargaining unit employees enrolled in the Medical Only plan shall be enrolled in the Full Coverage plan, and the Medical Only plan will eliminated. The rates for 2019 and a further description of the plan and rates are referenced

  • Special Services Should the Trust have occasion to request the Adviser to perform services not herein contemplated or to request the Adviser to arrange for the services of others, the Adviser will act for the Trust on behalf of the Fund upon request to the best of its ability, with compensation for the Adviser's services to be agreed upon with respect to each such occasion as it arises.

  • Pharmacy Services The Contractor shall establish a network of pharmacies. The Contractor or its PBM must provide at least two (2) pharmacy providers within thirty (30) miles or thirty (30) minutes from a member’s residence in each county, as well as at least two (2) durable medical equipment providers in each county or contiguous county.

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