In-Network Benefits. In-network benefits are the highest level of coverage available. In-network benefits apply when Your care is provided by Participating Providers who are located within Our Service Area. You should always consider receiving dental care services first through the in-network benefits portion of this Contract.
In-Network Benefits. In-network benefits are the highest level of coverage available. In-network benefits apply when Your care is provided by Participating Providers or Our affiliate’s network who are located within Our Service Area. You should always consider receiving dental care services first through the in-network benefits portion of this Contract. In-network care covered under this Contract must be provided, arranged or authorized in advance by Your Primary Care Dentist and, when required, approved by Us. In order to receive in-network benefits, You must contact Your Primary Care Dentist before You obtain the services except for Emergency Dental Care described in the Pediatric Dental Care section(s) of this Contract.
In-Network Benefits. In order to be eligible to enroll and participate in this Plan you must work for an employer Group that is headquartered in the State of New Mexico (our Service Area). Your Dependents may be eligible to enroll if they meet all of the terms and conditions for such Coverage as described in the Eligibility, Enrollment and Effective Dates, Termination and Continuation of Coverage Section. When you or your Covered Dependents receive care from Practitioners and Providers in our network (In-network Practitioners/Providers), the In-network benefit level will apply to the cost of the Healthcare Services. You will be responsible for your Cost Sharing amounts (Copayments, Deductibles or Coinsurance) at the time of service. As shown in your Summary of Benefits and Coverage, your benefit levels are highest and your Out-of- pocket Cost Sharing amounts are lowest when you use our In-network Practitioner/Providers. Your In-network Practitioner/Provider will xxxx us directly for the cost of services. You will generally not have claims to file or papers to fill out in order to be reimbursed for medical services obtained from In-network Practitioners and Providers. In-network Practitioners and Providers cannot xxxx you for any additional costs over and above your Cost Sharing amounts. Hospital Inpatient Admission and some other Healthcare Services require our review and Prior Authorization before the services are provided. If you seek care from an In-network Practitioner/Provider, your In-network Practitioner/Provider will notify us and handle all aspects of your care. Please refer to the Prior Authorization Section for complete details on Prior Authorization. Provider Directory You will find our In-network Practitioners/Providers close to where you live and work across the State. Our Provider Directory lists the In-network Practitioners, as well as In-network Hospitals,
In-Network Benefits. Subject to the specifications described in the Schedule of Vision Benefits, each Member will have coverage for:
In-Network Benefits the level of benefits providing lower Cost Sharing Amounts for Members as shown in the Summary of Benefits.
In-Network Benefits. In-network benefits are the highest level of coverage available. In-network benefits apply when Your care is provided by Participating Providers in Our Network affiliate’s EyeMed Network. You should always consider getting vision care services first through the in-network benefits portion of this Contract.
