Inpatient Hospitalization Sample Clauses

Inpatient Hospitalization. Enrollees receiving Inpatient Hospitalization services on the first effective date of enrollment will be enrolled in accordance with 3.6.1 and 3.6.2 above. All charges related to Inpatient Hospitalization for any Enrollee on the effective date of enrollment will not be the responsibility of the new MCO or FFS.
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Inpatient Hospitalization. We will cover Medical Expenses of an Insured Person in case of Medically Necessary Hospitalization arising from a Disease/ Illness or Injury provided such Medically Necessary Hospitalization is for more than 24 consecutive hours. We will pay Medical Expenses as shown in the Schedule for: a. Reasonable and Customary Charges for Room Rent for accommodation in Hospital room up to eligible Room Category or eligible Room Rent as per the Policy and specified in the Schedule to this Policy. b. Intensive Care Unit charges for accommodation in ICU , c. Operation theatre charges, d. Fees of Medical Practitioner/ Surgeon , e. Anaesthetist, f. Qualified Nurses, g. Specialists, h. Cost of diagnostic tests, i. Medicines, j. Drugs and consumables, blood, oxygen, surgical appliances and prosthetic devices recommended by the attending Medical Practitioner and that are used intra operatively during a Surgical Procedure. If the Insured Person is admitted in a room where the room category or the Room Rent incurred is higher than that which is specified in the Schedule to this Policy then the Policyholder/Insured Person shall bear a ratable proportion of the total Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the difference between the room rent of the entitled room category/eligible Room Rent to the Room Rent actually incurred. For the purpose of this Section “Associated Medical Expenses” shall include - Room Rent, Nursing Charges, Operation Theatre Charges, Fees of Medical Practitioner/Surgeon/ Anesthetist/ Specialist and Diagnostic Tests conducted within the same Hospital where the Insured Person has been admitted. All Claims under this benefit can be made as per the process defined under Section VII 4 & 5.
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Inpatient Hospitalization. We will cover Medical Expenses of an Insured Person in case of Medically Necessary Hospitalization arising from a Disease/ Illness or Injury provided such Medically Necessary Hospitalization is for more than 24 consecutive hours. We will pay Medical Expenses as shown in the Schedule for: a. Reasonable and Customary Charges for Room Rent for accommodation in Hospital room up to Category as per Plan opted and specified in the Schedule to this Policy. b. Intensive Care Unit charges for accommodation in ICU , c. Operation theatre charges, d. Fees of Medical Practitioner/ Surgeon , e. Anaesthetist, f. Qualified Nurses, g. Specialists, h. Cost of diagnostic tests, i. Medicines, j. Drugs and consumables, blood, oxygen, surgical appliances and prosthetic devices recommended by the attending Medical Practitioner and that are used intra operatively during a Surgical Procedure. Under the Protect, Plus & Accumulate Plans coverage is available up to a Single Private Room as defined in the Policy whereas with the Preferred and Premier Plan accommodation under any Room Category will be available excluding a suite. If the Insured Person is admitted in a room category that is higher than the one that is specified in the Schedule to this Policy then the Policyholder/Insured Person shall bear a ratable proportion of the total Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the difference between the room rent of the entitled room category to the room rent actually incurred. For the purpose of this Section “Associated Medical Expenses” shall include - Room Rent, Nursing Charges, Operation Theatre Charges, Fees of Medical Practitioner/Surgeon/ Anesthetist/ Specialist and Diagnostic Tests conducted within the same Hospital where the Insured Person has been admitted. All Claims under this benefit can be made as per the process defined under Section VII 4 & 5.
Sample 1Sample 2
Inpatient Hospitalization. We will cover Medical Expenses of an Insured Person in case of Medically Necessary Hospitalization arising from Accident or Illness provided such Medically Necessary Hospitalization is for more than 24 consecutive hours. We will pay Medical Expenses as shown in the Schedule for: a. Reasonable and Customary Charges for Room Rent for accommodation in Hospital room up to Category as per Plan opted and specified in the Schedule to this Policy. b. Intensive Care Unit charges for accommodation in ICU , c. Operation theatre charges, d. Fees of Medical Practitioner/ Surgeon , e. Anaesthetist, f. Qualified Nurses, g. Specialists, h. Cost of diagnostic tests, i. Medicines, j. Drugs and consumables, blood, oxygen, surgical appliances and prosthetic devices recommended by the attending Medical Practitioner and that are used intra operatively during a Surgical Procedure. If the Insured Person is admitted in a room category that is higher than the one that is specified in the Schedule to this Policy then the Policyholder/Insured Person shall bear a ratable proportion of the total Associated Medical Expenses (including surcharge or taxes thereon) in the proportion of the difference between the room rent of the entitled room category to the room rent actually incurred. For the purpose of this Section “Associated Medical Expenses” shall include - Room Rent, Nursing Charges, Operation Theatre Charges, Fees of Medical Practitioner/Surgeon/ Anaesthetist/ Specialist and Diagnostic Tests conducted within the same Hospital where the Insured Person has been admitted. All Claims under this benefit can be made as per the process defined under Section VII 4 & 5.
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Inpatient Hospitalization. There is a $50.00 copayment for inpatient hospitalization.
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Related to Inpatient Hospitalization

  • Inpatient If you are an inpatient in a general or specialty hospital for mental health services, this agreement covers medically necessary hospital services and the services of an attending physician for the number of hospital days shown in the Summary of Medical Benefits. See Section

  • Outpatient If you receive infusion therapy services in a hospital's outpatient unit, we cover the use of the treatment room, related supplies, and solutions. For prescription drug coverage, see Section 3.27

  • Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.

  • Dental Care Plan The Welfare Plan will include a Dental Care Plan which will reimburse members for expenses incurred in respect of the coverages summarized in Appendix "1". The Plan will not duplicate benefits provided now or which may be provided in the future by any government program.

  • HEALTH PROGRAM 3701 Health examinations required by the Employer shall be provided by the Employer and shall be at the expense of the Employer. 3702 Time off without loss of regular pay shall be allowed at a time determined by the Employer for such medical examinations and laboratory tests, provided that these are performed on the Employer’s premises, or at a facility designated by the Employer. 3703 With the approval of the Employer, a nurse may choose to be examined by a physician of her/his own choice, at her/his own expense, as long as the Employer receives a statement as to the fitness of the nurse from the physician. 3704 Time off for medical and dental examinations and/or treatments may be granted and such time off, including necessary travel time, shall be chargeable against accumulated income protection benefits.

  • Dependent Care Assistance Program The County offers the option of enrolling in a Dependent Care Assistance Program (DCAP) designed to qualify for tax savings under Section 129 of the Internal Revenue Code, but such savings are not guaranteed. The program allows employees to set aside up to five thousand dollars ($5,000) of annual salary (before taxes) per calendar year to pay for eligible dependent care (child and elder care) expenses. Any unused balance is forfeited and cannot be recovered by the employee.

  • Prosthodontics We Cover prosthodontic services as follows:

  • Orthodontics We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias.

  • Medical Examination Where the Employer requires an employee to submit to a medical examination or medical interview, it shall be at the Employer's expense and on the Employer's time.

  • HEALTH CARE PLANS ‌ Notwithstanding the references to the Pacific Blue Cross Plans in this article, the parties agree that Employers, who are not currently providing benefits under the Pacific Blue Cross Plans may continue to provide the benefits through another carrier providing that the overall level of benefits is comparable to the level of benefits under the Pacific Blue Cross Plans.

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