Plan Deductible Sample Clauses

Plan Deductible. Delta Dental shall not be obligated to pay or otherwise discharge, in whole or in part, the first Fifty Dollars ($50) of fees for Classes II and III services rendered an eligible Subscriber or eligible Dependent during the period of each benefit year covered under this Plan. Such deductible shall not exceed three (3) individual deductibles per family per benefit year. Such deductible shall not apply to Class I services rendered an eligible Subscriber or eligible Dependent or to Class IV services rendered an eligible dependent child.

Plan Deductible. The Plan Deductible is a dollar amount of Usual and Customary Charges for Medically Necessary Covered Medical Services which must be incurred as an out-of-pocket expense by each Insured due to any one Injury or Sickness before benefits are payable for those services. Benefits are not payable for charges applied to the Plan Deductible. The Insured is responsible for payment of the Plan Deductible. The Plan Deductible is shown in the Schedule of Benefits. Charges Incurred in the Insured’s Home Country Under the following circumstances, benefits will be payable for charges incurred for Covered Medical Services provided in the Insured’s Home Country: • If an Insured’s coverage ends because a Covered Trip ends, and that Insured has a medical condition that was diagnosed while on the Covered Trip and while in the Host Country, benefits will be payable for treatment of that condition in the Home Country for a maximum of 90 days from the date coverage ends. • If, while on a Covered Trip, the Insured returns to his or her Home Country for a break or visit, benefits will be payable for treatment of a covered medical condition that is provided in the Home Country, subject to the Home Country Maximum shown in the Schedule of Benefits.

Plan Deductible. In the event the County implements a change of plan year dates, amounts that employees have accrued toward required deductibles or co- insurances during the partial plan year shall be applied to the deductible required during new plan year.

Plan Deductible. The Plan Deductible includes Covered Services and Supplies to be paid by you or your Dependent before benefits are payable under this plan. Deductibles are in addition to any Coinsurance. Once the Deductible maximum in The Schedule has been reached, you and your family need not satisfy any further medical deductible for the rest of that year. The Individual Deductible is the amount you are responsible for paying out-of-pocket, each Contract Year, for covered Prescription Drugs Products (as identified in the Supplemental Prescription Drug Rider) and Covered Services and Supplies (as identified in the Group Service Agreement). You must meet your Individual Deductible before the Healthplan begins to pay the cost associated with your coverage. However, when the amount paid by individuals in your Membership Unit to meet their Individual Deductibles equals the Family Deductible amount, all Members in the Membership Unit will be considered to have met their Individual Deductible for that Contract Year. Prepayment Fee The sum of money paid to the Healthplan by the Group in order for you to receive the Services and Supplies covered by this Agreement. Primary Care Physician (PCP) A Physician who practices general medicine, family medicine, internal medicine or pediatrics who, through an agreement with the Healthplan, provides basic health care services to you if you have chosen him as your Primary Care Physician (PCP). Your Primary Care Physician (PCP) also arranges specialized services for you. Primary Plan The Plan that determines and provides or pays its benefits without taking into consideration the existence of any other Plan.