Hospital / Medical Services Sample Clauses

Hospital / Medical Services. Child Care During Hospitalization ▪ Coverage for the services of a caregiver (other than an immediate family member) for covered dependent(s) under the age of 18 in the event a parent or legal guardian on the trip must be repatriated or hospitalized. The age limit is waived for dependents who are mentally or physically incapacitated. Drugs or Medicines ▪ Drugs or medicines which are prescribed by a prescriber and dispensed by a pharmacist, excluding vitamins and vitamin preparations, over the counter drugs, or patent and proprietary medicines available without a written prescription from a prescriber. Hospital In-patient Allowance ▪ An allowance of $40 per day for each day the participant is hospitalized as an in-patient to a benefit maximum $1,000. Hospital Services ▪ Hospital in-patient and out-patient services and supplies provided by a licensed hospital excluding any charges not paid by or on behalf of the participant, or that the participant was otherwise entitled to be reimbursed for. ▪ Medical and surgical services by a physician. Medical Appliances ▪ Essential minor medical appliances such as casts, canes, crutches, splints, slings, etc. and/or temporary rental of a wheelchair when prescribed by the attending physician. Paramedical ▪ Physiotherapy when provided in a hospital. ▪ Services of a chiropractor and/or a podiatrist. A letter from the attending physician must be presented indicating treatment was for acute rather than chronic care. Private Duty Nursing ▪ Private duty nursing care during or immediately following hospitalization as an in-patient. The services must be provided by a professional nurse registered in the place where the service was provided. The services must have been recommended by the attending physician and the nurse must not be a family member of the patient. Replacement of Eyeglasses or Contact LensesRepair or replacement of prescription eyeglasses or contact lens or lenses up to a benefit maximum of $100 in the event of injury resulting in the loss or breakage of eyeglasses or loss or breakage of a contact lens or lenses. The injury must be treated by a physician or dentist for the charges to be eligible. Emergency Dental CareDental care service to natural teeth when necessitated by a direct accidental blow to the mouth only, and not by an object wittingly or unwittingly placed in the mouth. Treatment must be rendered within 180 days following the date of the accident in order to be considered an eligible expense. Be...
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Related to Hospital / Medical Services

  • Surgical Services All necessary procedures for extractions and other surgical procedures normally performed by a dentist.

  • Medical Services We do not Cover medical services or dental services that are medical in nature, including any Hospital charges or prescription drug charges.

  • Hospital Services The Hospital will: 6.1.1 achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; 6.1.2 not reduce, stop, start, expand, cease to provide or transfer the provision of Hospital Services to another hospital or to another site of the Hospital if such action would result in the Hospital being unable to achieve the Performance Standards described in the Schedules and the HSAA Indicator Technical Specifications; and 6.1.3 not restrict or refuse the provision of Hospital Services that are funded by the Funder to an individual, directly or indirectly, based on the geographic area in which the person resides in Ontario, and will establish a policy prohibiting any health care professional providing services at the Hospital, including physicians, from doing the same.

  • Medical Services Plan Regular Full-Time and Temporary Full-Time Employees shall be entitled to be covered under the Medical Services Plan commencing the first day of the calendar month following the date of employment. The City shall pay one hundred percent (100%) of the premiums required by the plan.

  • Dental Services The following dental services are not covered, except as described under Dental Services in Section 3: • Dental injuries incurred as a result of biting or chewing. • General dental services including, but not limited to, extractions including full mouth extractions, prostheses, braces, operative restorations, fillings, frenectomies, medical or surgical treatment of dental caries, gingivitis, gingivectomy, impactions, periodontal surgery, non-surgical treatment of temporomandibular joint dysfunctions, including appliances or restorations necessary to increase vertical dimensions or to restore the occlusion. • Panorex x-rays or dental x-rays. • Orthodontic services, even if related to a covered surgery. • Dental appliances or devices. • Preparation of the mouth for dentures and dental or oral surgeries such as, but not limited to, the following: o apicoectomy, per tooth, first root; o alveolectomy including curettage of osteitis or sequestrectomy; o alveoloplasty, each quadrant; o complete surgical removal of inaccessible impacted mandibular tooth mesial surface; o excision of feberous tuberosities; o excision of hyperplastic alveolar mucosa, each quadrant; o operculectomy excision periocoronal tissues; o removal of partially bony impacted tooth; o removal of completely bony impacted tooth, with or without unusual surgical complications; o surgical removal of partial bony impaction; o surgical removal of impacted maxillary tooth; o surgical removal of residual tooth roots; and o vestibuloplasty with skin/mucosal graft and lowering the floor of the mouth. • The following dialysis services received in your home: o installing or modifying of electric power, water and sanitary disposal or charges for these services; o moving expenses for relocating the machine; o installation expenses not necessary to operate the machine; and o training in the operation of the dialysis machine when the training in the operation of the dialysis machine is billed as a separate service. • Dialysis services received in a physician’s office.

  • 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.

  • Clinical Management for Behavioral Health Services (CMBHS) System 1. request access to CMBHS via the CMBHS Helpline at (000) 000-0000. 2. use the CMBHS time frames specified by System Agency. 3. use System Agency-specified functionality of the CMBHS in its entirety. 4. submit all bills and reports to System Agency through the CMBHS, unless otherwise instructed.

  • Surgery Services This plan covers surgery services to treat a disease or injury when: • the operation is not experimental or investigational, or cosmetic in nature; • the operation is being performed at the appropriate place of service; and • the physician is licensed to perform the surgery. This plan covers reconstructive surgery and procedures when the services are performed to relieve pain, or to correct or improve bodily function that is impaired as a result of: • a birth defect; • an accidental injury; • a disease; or • a previous covered surgical procedure. Functional indications for surgical correction do not include psychological, psychiatric or emotional reasons. This plan covers the procedures listed below to treat functional impairments. • abdominal wall surgery including panniculectomy (other than an abdominoplasty); • blepharoplasty and ptosis repair; • gastric bypass or gastric banding; • nasal reconstruction and septorhinoplasty; • orthognathic surgery including mandibular and maxillary osteotomy; • reduction mammoplasty; • removal of breast implants; • removal or treatment of proliferative vascular lesions and hemangiomas; • treatment of varicose veins; or • gynecomastia.

  • 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.

  • Technical Services Party B will provide technical services and training to Party A, taking advantage of Party B’s advanced network, website and multimedia technologies to improve Party A’s system integration. Such technical services shall include: (a) administering, managing and maintaining Party A’s information application system and website system infrastructure; (b) providing system optimization plans and implementing optimization features; (c) assuring the security and reliability of the website application systems; (d) procuring, installing and supporting the relevant products produced by Party B, and providing training in the use of those products; (e) managing and maintaining all network and providing technologies to assure the reliability and efficiency thereof; (f) providing information technology services and assuring the reliable operation of the information infrastructure.

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