Common use of Services of Preferred Dentists Clause in Contracts

Services of Preferred Dentists. SAMPLE 1. Many Participating Dentists have special agreements with CareFirst and are part of a network of Preferred Dentists. In general, if a Member chooses a Preferred Dentist, the cost to the Member is lower than if the Member chooses a Non- Preferred Dentist. In the Schedule of Benefits, the Coinsurance percentages are listed as either “In-Network” (for a Preferred Dentist) or “Out-of-Network” (for a Non-Preferred Dentist). 2. If a Preferred Dentist is not reasonably available when a Member requires emergency care (Palliative Treatment and/or Emergency Oral Exam), benefits will be paid based on the "In-Network" Coinsurance percentage listed in the Schedules of Benefits. Participating Dentists will accept the Allowed Benefit as payment in full, except for any applicable Deductible and Coinsurance amounts for which the Member is responsible. Non-Participating Dentists may xxxx the Member for the difference between the CareFirst payment and the Non- Participating Dentist's charge.

Appears in 3 contracts

Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement

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Services of Preferred Dentists. SAMPLE 1. Many Participating Dentists have special agreements with CareFirst BlueChoice and are part of a network of Preferred Dentists. In general, if a Member chooses a Preferred Dentist, the cost to the Member is lower than if the Member chooses a Non- Non-Preferred Dentist. In the Schedule of Benefits, the Coinsurance percentages are listed as either “In-Network” (for a Preferred Dentist) or “Out-of-of- Network” (for a Non-Preferred Dentist).. SAMPLE 2. If a Preferred Dentist is not reasonably available when a Member requires emergency care (Palliative Treatment and/or Emergency Oral Exam), benefits will be paid based on the "In-Network" Coinsurance percentage listed in the Schedules of Benefits. Participating Dentists will accept the Allowed Benefit as payment in full, except for any applicable Deductible and Coinsurance amounts for which the Member is responsible. Non-Participating Dentists may xxxx the Member for the difference between the CareFirst BlueChoice payment and the Non- Non-Participating Dentist's charge.

Appears in 3 contracts

Samples: Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement for a Qualified Health Plan, Individual Enrollment Agreement

Services of Preferred Dentists. SAMPLE 1. Many Participating Dentists have special agreements with CareFirst and are part of a network of Preferred Dentists. In general, if a Member chooses a Preferred Dentist, the cost to the Member is lower than if the Member chooses a Non- Preferred Dentist. In the Schedule of Benefits, the Coinsurance percentages are listed as either “In-Network” (for a Preferred Dentist) or “Out-of-Network” (for a Non-Preferred Dentist). 2. If a Preferred Dentist is not reasonably available when a Member requires emergency care (Palliative Treatment and/or Emergency Oral Exam), benefits will be paid based on the "In-Network" Coinsurance percentage listed in the Schedules of Benefits. Participating Dentists will accept the Allowed Benefit as payment in full, except for any applicable Deductible and Coinsurance amounts for which the Member is responsible. Non-Participating Dentists may xxxx bill the Member for the difference between the CareFirst payment and the Non- Participating Dentist's charge.

Appears in 1 contract

Samples: Individual Enrollment Agreement

Services of Preferred Dentists. SAMPLE 1. Many Participating Dentists have special agreements with CareFirst BlueChoice and are part of a network of Preferred Dentists. In general, if a Member chooses a Preferred Dentist, the cost to the Member is lower than if the Member chooses a Non- Non-Preferred Dentist. In the Schedule of Benefits, the Coinsurance percentages are listed as either “In-Network” (for a Preferred Dentist) or “Out-of-of- Network” (for a Non-Preferred Dentist).. Sample 2. If a Preferred Dentist is not reasonably available when a Member requires emergency care (Palliative Treatment and/or Emergency Oral Exam), benefits will be paid based on the "In-Network" Coinsurance percentage listed in the Schedules of Benefits. Participating Dentists will accept the Allowed Benefit as payment in full, except for any applicable Deductible and Coinsurance amounts for which the Member is responsible. Non-Participating Dentists may xxxx the Member for the difference between the CareFirst BlueChoice payment and the Non- Non-Participating Dentist's charge.

Appears in 1 contract

Samples: Individual Enrollment Agreement for a Qualified Health Plan

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Services of Preferred Dentists. SAMPLE 1. Many Participating Dentists have special agreements with CareFirst BlueChoice and are part of a network of Preferred Dentists. In general, if a Member chooses a Preferred Dentist, the cost to the Member is lower than if the Member chooses a Non- Non-Preferred Dentist. In the Schedule of Benefits, the Coinsurance percentages are listed as either “In-Network” (for a Preferred Dentist) or “Out-of-of- Network” (for a Non-Preferred Dentist). 2. If a Preferred Dentist is not reasonably available when a Member requires emergency care (Palliative Treatment and/or Emergency Oral Exam), benefits will be paid based on the "In-Network" Coinsurance percentage listed in the Schedules of Benefits. Participating Dentists will accept the Allowed Benefit as payment in full, except for any applicable Deductible and Coinsurance amounts for which the Member is responsible. Non-Participating Dentists may xxxx the Member for the difference between the CareFirst BlueChoice payment and the Non- Non-Participating Dentist's charge.

Appears in 1 contract

Samples: Individual Enrollment Agreement

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