Common use of PHYSICIAN BENEFITS Clause in Contracts

PHYSICIAN BENEFITS. This section of your Certificate explains what your benefits are when you receive care from a Physician. Remember, to receive benefits for Covered Services, (except for the treatment of Mental Illness other than Serious Mental Illness), they must be performed by or ordered by your Primary Care Physician or Woman's Principal Health Care Pro­ vider. In addition, only services performed by Physicians are eligible for benefits unless another Provider, for example, a Dentist, is specifically mentioned in the description of the service. Whenever we use “you” or “your” in describing your benefits, we mean all eligi­ ble family members who are covered under Family Coverage. COVERED SERVICES Your coverage includes benefits for the following Covered Services: Surgery — when performed by a Physician, Dentist or Podiatrist or other Pro­ vider acting within the scope of his/her license. However, benefits for oral Surgery are limited to the following services: