Allowable Benefit definition

Allowable Benefit as used in this subsection, means the total charge for a service or supply specified in this Agreement for which benefits will be provided, to the extent that such service or supply is covered by this and/or the Other Contract.
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Allowable Benefit means a benefit relating to medical, surgical, or hospital care in the event of
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Allowable Benefit means a benefit relating to medical, surgical, or hospital care in the event of sickness, accident, disability, or any combination of sickness, accident, or disability.
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Examples of Allowable Benefit in a sentence

  • This Plan will always pay either its regular benefits in full if it is determined to be the Primary Plan (Plan primarily responsible for payment) or, if the Plan is determined to be the Secondary Plan, a reduced amount which, when added to the benefits payable by the Primary Plan, will equal no more than the Allowable Benefit under This Plan.

  • When You use Out-of-Network providers, You are subject to paying any balance over and above the Maximum Allowable Benefit schedule.The Fund is required to furnish You upon request and without charge, a list of its Network of dental providers.

  • Maximum Allowable Benefit: The maximum allowable benefit shall mean the benefit payable for a specific coverage item or benefit under this Plan.

  • If the fees of Out-of-Network providers are greater than the amounts paid under your MCTWF Actives Plan and MCTWF Retirees Plan’s Out-of-Network Maximum Allowable Benefit schedule, You will be responsible for paying the balance or the full amount if You have reached your Annual per person maximum.

  • Maximum Allowable Benefit: An amount a provider is allow ed for a particular service.

  • Schmidt also ordered that the parties bear their own attorney’s fees and costs.

  • B) Maximum Allowable Benefit: The maximum annual benefit paid for this type of disability is equal to 2/3rds (66.67%) of your Average Annual Pay, minus any benefits you receive from Social Security.

  • This program was one of the plotting methods created for the SPHS library, but was abandoned since it offers little advantage over either a full IDE or the F# interactive console, while not benefiting from the features of either.

  • When you use Out-of-Network providers, you are subject to paying any balance over and above the Maximum Allowable Benefit schedule.

  • However, You will be responsible for any balance billed by the provider in excess of the Fund’s Maximum Allowable Benefit amounts.3.2(a) NON- ACCESS EXEMPTION APPLICATION Your Application must be received by the Fund within 60 Days following the date of receipt of Out-of-Network services.


More Definitions of Allowable Benefit

Allowable Benefit means a benefit to provide medical, surgical, or hospital care or benefits.
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Related to Allowable Benefit

  • Charitable Beneficiary means one (1) or more beneficiaries of the Trust as determined pursuant to Section 5.9(iii)(f), provided that each such organization must be described in Section 501(c)(3) of the Code and contributions to each such organization must be eligible for deduction under each of Sections 170(b)(1)(A), 2055 and 2522 of the Code.

  • Secured Parties means, collectively, the Administrative Agent, the Lenders, the L/C Issuers, the Hedge Banks, the Cash Management Banks, each co-agent or sub-agent appointed by the Administrative Agent from time to time pursuant to Section 9.05, and the other Persons the Obligations owing to which are or are purported to be secured by the Collateral under the terms of the Collateral Documents.

  • Advanced practice nurse means a person who holds current certification as nurse practitioner/clinical nurse specialist from the State Board of Nursing.

  • Allowable Expenses means any necessary, reasonable and customary item of expense at least a portion of which is covered under at least one of the Health Benefit Plans covering the person for whom claim is made. When a Health Benefit Plan provides benefits in the form of coverage for services, the reasonable cash value of each service rendered shall be deemed to be both an Allowable Expense and a benefit paid.

  • Allowable Expense means a necessary, reasonable and customary item of expense for health care, which is: • covered at least in part under one or more plans covering the person for whom the claim is made; and • incurred while this plan is in force. When a plan provides healthcare coverage in the form of services, the reasonable cash value of each service is considered as both an allowable expense and a benefit paid. Vision care services covered under other plans are not considered an allowable expense under this plan. PLAN means any of the following that provides benefits or services for medical, pharmacy, or dental care treatment. If separate contracts are used to provide coordinated coverage for members of a group, the separate contracts are considered parts of the same plan and there is no COB among those separate contracts.