Outpatient Benefits. You are entitled to benefits for the following services when you receive them from a Hospital, or other specified Provider, on an Outpatient basis:
Outpatient Benefits. Pre-Hospital Diagnostic Tests As Charged Pre-Hospital Specialist Consultation As Charged Post Hospitalisation Treatment As Charged Emergency Accidental Outpatient Treatment As Charged Outpatient Physiotherapy Treatment As Charged Outpatient Kidney Dialysis Treatment As Charged Outpatient Cancer Treatment As Charged Emergency Accidental Outpatient Dental Treatment (RM) 4,000 (per accident) Home Nursing Care (RM) 4,000 Second Surgical Opinion As Charged
Outpatient Benefits. Preadmission testing and/or surgery expenses are subject to deductible and benefit percentage (coinsurance clause). “Dependent of a dependent” are excluded from this health plan. The Company will amend its current medical insurance plan so that any employee or spouse of an employee covered by the medical plan that is or becomes disabled will continue to be covered by the Company’s health insurance coverage to the extent covered, prior to such disability. The Company will raise the Maximum lifetime cap under the medical plan from $1,000,000.00 to $2,000,000.00.
Outpatient Benefits. A Covered Person is entitled to benefits for Covered Services on an Outpatient basis when deemed Medically Appropriate/Medically Necessary and billed for by a Provider. Payment allowances for Covered Services and any Precertification and other cost-sharing requirements are specified in the Schedule of Benefits.
Outpatient Benefits. Except in an emergency as described in Section II.G of this Contract, the following services will be provided to Members when medically necessary and only at or through the Primary Care Physician's office that is shown on Member's Identification Card, or elsewhere upon prior written referral by Member's Primary Care Physician:
1. Office visits during office hours, and during non-office hours when medically necessary. Member is responsible for a copayment for each such visit in the amount shown on the Copayment Schedule, as may be amended from time to time upon filing with and approval by the applicable public authority and agreed to by the Contract Holder, (hereinafter the "current Copayment Schedule").
2. Home visits by Member's Primary Care Physician when medically necessary. Member is responsible for a copayment for each home visit in the amount shown on the current Copayment Schedule.
3. Periodic health evaluations to include:
a. Well child care from birth including immunizations and booster doses of all immunizing agents used in child immunizations which, as determined by the Pennsylvania Department of Health conform to the standards of the (Advisory Committee on Immunization Practices of the Center for disease Control), U.S. Department of Health and Human Services Immunization benefits are exempt from deductible and dollar limits; b Routine physical examinations;
Outpatient Benefits. Benefits for Outpatient office visits for Substance Use Disorder Treatment will be paid at 100% of the Provider's Charge. Covered Services received for detoxification are not subject to the Substance Use Disorder Treatment provisions specified above. Benefits for Covered Ser vices received for detoxification will be provided under the HOSPITAL BENEFITS and PHYSICIAN BENEFITS sections of this Certificate, as for any other condition. AWAY FROM HOME CARE® BENEFITS The Plan is a participant in a nation‐wide network of Blue Cross and Blue Shield‐affiliated plans. This enables the Plan to provide you with Guest Mem bership benefits when you are outside the service‐area of the Plan.
