Paramedical Coverage Clause Samples
The Paramedical Coverage clause defines the extent to which an insurance policy covers services provided by paramedical practitioners, such as physiotherapists, chiropractors, or massage therapists. Typically, this clause outlines the types of paramedical services included, any annual or per-visit limits, and whether a referral from a physician is required for reimbursement. Its core function is to clarify the scope and limitations of coverage for non-physician health services, helping policyholders understand what expenses will be reimbursed and preventing disputes over eligible claims.
Paramedical Coverage. Effective April 1, 2012, additions to the ONA Benefit Plan for nurses shall include annual coverage for the following:
(a) Chiropractors - $500.00.
(b) Dieticians - $500.00.
(c) Physiotherapists - $1,000.00.
(d) Podiatrists - $500.00.
(e) Naturopaths - $500.00.
(f) Osteopaths - $500.00.
(g) Psychologists/Social Workers - $500.00.
(h) Speech Therapists - $500.00.
(i) Massage Therapists - $500.00.
(j) Acupuncturists - $500.00.
Paramedical Coverage. The current paramedical coverage will have the maximum payment changed to five hundred dollars ($500) per year with each visit compensated at eighty (80%).
Paramedical Coverage. The Extended Health Care Plan shall include the following paramedical services: Physiotherapist maximum $700 per calendar year Clinical Psychologist maximum $350 per calendar year Speech Pathologist maximum $350 per calendar year Chiropractor maximum $700 per calendar year Massage without Dr. Note (must be a Certified Registered or Licenced Massage Therapist) maximum $350 per calendar year Osteopath maximum $350 per calendar year Podiatrist maximum $350 per calendar year Chiropodist maximum $350 per calendar year Naturopath maximum $350 per calendar year In addition, the insurance carrier will be instructed to modify the existing policy to provide for the mandatory dispensing of a generic substitution whenever a generic drug is available unless the prescribing doctor indicates no generic substitution. The carrier will be advised to instruct pharmacists to ignore pre-printed statements on doctor’s scripts stating no generic substitution.
Paramedical Coverage. The Company will pay $300 for paramedical coverage each calendar year.
Paramedical Coverage. (a) Company Arrangements
Paramedical Coverage. Increase current paramedical coverage to $500 maximum per year per practitioner with no per-visit maximum. To be revised following the implementation of the Job Evaluation System.
Paramedical Coverage. The Extended Health Care Plan shall include the following paramedical services: (effective 1st day of the month following date of ratification) Physiotherapist maximum $950 per calendar year Clinical Psychologist (including Therapist, Psychiatrist, Psychotherapist and Social Work maximum $5000 per calendar year per member Speech Pathologist maximum $550 per calendar year Chiropractor maximum $950 per calendar year Massage without Dr. Note (must be a Certified Registered or Licenced Massage Therapist) maximum $750 per calendar year Acupuncture Osteopath $350 per calendar year maximum $500 per calendar year Podiatrist maximum $500 per calendar year Chiropodist maximum $500 per calendar year Naturopath maximum $350 per calendar year The insurance carrier will be instructed to modify the existing policy to provide for the mandatory dispensing of a generic substitution whenever a generic drug is available unless the prescribing doctor indicates no generic substitution. The carrier will be advised to instruct pharmacists to ignore pre-printed statements on doctor’s scripts stating no generic substitution. The plan is to also include coverage for the following: • Fertility Drugs • Sexual Dysfunction Drugs $300/year
Paramedical Coverage. Effective upon Ratification, a Seven Hundred and Fifty Dollars ($750) combined annual maximum per participant per calendar year for the following:
a) acupuncture, b) chiropractic, c) massage therapist, d) naturopath, e) physiotherapist, f) podiatrist/chiropodist, g) speech language pathologist.
Paramedical Coverage. Effective August 3 2012: The Company will arrange to provide a combined benefit of up to $300 per year for existing paramedical services with the requirement that services must be prescribed by a Physician. (Chiropractic, Massage Therapy, Osteopathatic, Psychologist, Speech Therapist). Effective August 3, 2013, the combined amount will be increased to $350. The Company will arrange to provide a benefit of up to $150 per year for Massage Therapy coverage (for services prescribed by a Physician and preformed by a registered massage therapist). The Company will arrange to provide hearing aid coverage up to $500/5 years. Effective the pay period closest to the middle of November, 2008. The Company will arrange to provide a benefit for breast prostheses and wigs at the insurer’s reasonable and customary level. Effective the pay period closest to the middle of November, 2008.
Paramedical Coverage. The Extended Health Care Plan shall include the following paramedical services: Clinical Psychologist (including Therapist, Psychiatrist, Psychotherapist and Social Work) maximum $1000 per calendar year Speech Pathologist maximum $350 per calendar year Massage without Dr. Note (must be a Certified Registered or Licenced Massage Therapist) maximum $400 per calendar year Osteopath maximum $500 per calendar year Podiatrist maximum $500 per calendar year Chiropodist maximum $500 per calendar year The insurance carrier will be instructed to modify the existing policy to provide for the mandatory dispensing of a generic substitution whenever a generic drug is available unless the prescribing doctor indicates no generic substitution. The carrier will be advised to instruct pharmacists to ignore pre-printed statements on doctor’s scripts stating no generic substitution.