Benefit limits definition

Benefit limits means the annual limits and sub limits as spelt out in the medical circular.
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Benefit limits means the specified limitations, exclusions or restrictions applicable to Benefits within a Benefit Period;
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Benefit limits. Physical Medicine: Limited to fifteen (15) visits per calendar year. Speech and Occupational Limited to a combined total of Therapy: fifteen (15) visits per calendar year.
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Examples of Benefit limits in a sentence

  • Benefit limits are calculated on a calendar year basis unless otherwise specifically stated.

  • Benefit limits, the amount you pay, and whether a service is covered can differ based on whether a member is under age nineteen (19) or age nineteen (19) and older.

  • Please review all limits carefully, as we will not pay Benefits for any of the services, treatments, items or supplies that exceed these Benefit limits.

  • See the specific benefits in this section and the Benefits for covered services are subject to the following:  Copays  Deductibles  Coinsurance  Benefit limits  Prior Authorization.

  • Schedule of Benefits Information Table Benefit limits are calculated on a calendar year basis unless otherwise specifically stated.

  • Additionally, Members will receive written notification of any denial of coverage that is based on non-covered Benefits or Benefit limits that have been reached (known as an Adverse Benefit Determination).

  • See the specific benefits in this section and the Benefits for covered services are subject to the following: • Copays • Deductibles • Coinsurance • Benefit limits • Prior Authorization.

  • Owner will also be responsible for the costs of all processing, handling, operation equipment and planting needs.

  • Air Ambulance: 40% Yes Yes Depending upon the Covered Health Care Service, Benefit limits are the same as those stated under the specific Benefit category in this Schedule of Benefits.

  • Benefits for covered services are subject to the following: • Copays • Deductibles • Coinsurance • Benefit limits • Prior Authorization.

Related to Benefit limits

  • BENEFIT LIMIT means the total benefit allowed under this plan for a covered healthcare service. The benefit limit may apply to the amount we pay, the duration, or the number of visits for a covered healthcare service.

  • Annual Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder in a Policy Year irrespective of whether any limits of any benefit items stated in the Benefit Schedule have been reached. The Annual Benefit Limit is counted afresh in a new Policy Year.

  • Lifetime Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder cumulatively since the inception of these Terms and Benefits, irrespective whether any limits of any benefit items stated in the Benefit Schedule have been reached or whether the Annual Benefit Limit in a Policy Year has been reached.

  • benefit liabilities has the meaning specified in section 4001 of ERISA and the terms “current value” and “present value” have the meaning specified in section 3 of ERISA.

  • Foreign Benefit Law means any applicable statute, law, ordinance, code, rule, regulation, order or decree of any foreign nation or any province, state, territory, protectorate or other political subdivision thereof regulating, relating to, or imposing liability or standards of conduct concerning, any Employee Benefit Plan.