Network Providers. If your claim from a Network Provider is approved, the Plan will pay Benefits directly to the Network Provider. Except for your Out-of-Pocket Costs, if applicable, you are not required to pay any balances to the Network Provider until the Plan determines what it will pay. If you receive services from a Network Provider that are not Covered Services, you will be responsible for the cost of those non-Covered Services. If a Network Provider, who is licensed to perform alternative or complementary treatment and therapy, who is operating within the scope of his or her license and provides services that are listed as Covered Services, your cost-sharing responsibility is outlined in the Schedule of Benefits.
Appears in 8 contracts
Samples: Member Benefit Agreement, Member Benefit Agreement, Member Benefit Agreement
Network Providers. If your claim from a Network Provider is approved, the Plan will pay Benefits directly to the Network Provider. Except for your Out-of-Pocket Out‐of‐Pocket Costs, if applicable, you are not required to pay any balances to the Network Provider until the Plan determines what it will pay. If you receive services from a Network Provider that are not Covered Services, you will be responsible for the cost of those non-Covered non‐Covered Services. If a Network Provider, who is licensed to perform alternative or complementary treatment and therapy, who is operating within the scope of his or her license and provides services that are listed as Covered Services, your cost-sharing cost‐sharing responsibility is outlined in the Schedule of Benefits.
Appears in 2 contracts
Network Providers. If your claim from a Network Provider is approved, the Plan will pay Benefits directly to the Network Provider. Except for your Out-of-Pocket Costs, if applicable, you are not required to pay any balances to the Network Provider until the Plan determines what it will pay. SAMPLE If you receive services from a Network Provider that are not Covered Services, you will be responsible for the cost of those non-Covered Services. If a Network Provider, who is licensed to perform alternative or complementary treatment and therapy, who is operating within the scope of his or her license and provides services that are listed as Covered Services, your cost-sharing responsibility is outlined in the Schedule of Benefits.
Appears in 2 contracts