Calendar Year Deductible definition

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable Calendar Year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each Calendar Year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Covered Employee and Covered Dependents.

Calendar Year Deductible means the first dollar amount of your Part A and/or Part B charges incurred outside of the United States during a Calendar Year.

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Contractholder and Covered Dependents. Third-party Copayment assistance (sometimes also referred to as a “copay card” or “copay coupon”) provided by a drug manufacturer toward your cost-sharing for Covered Services including Specialty Medications, does not apply toward satisfaction of the Deductible.

Examples of Calendar Year Deductible in a sentence

• When you receive Covered Services from a Participating Provider, you are only responsible for the Copayment or Coinsurance, once any Calendar Year Deductible has been met.Teladoc.

• When you receive Covered Services from a Participating Provider, you are only responsible for the Copayment or Coinsurance, once any Calendar Year Deductible has been met.

• Up to the number of days or visits shown for each category of Extended Care Expense on your Schedule of Coverage.If shown on your Schedule of Coverage, the Calendar Year Deductible will apply.

• When you receive Covered Services from a Non-Participating Provider, you are responsible for:• the Copayment or Coinsurance (once any Calendar Year Deductible has been met), and• any charges above the Allowable Amount.

• If shown on your Schedule of Coverage, the Calendar Year Deductible will apply.

• When you receive Covered Services from a Participating Provider, you are only responsible for the Copayment or Coinsurance, once any Calendar Year Deductible has been met.Your payment for services from “Other Providers.” You will pay the Copayment or Coinsurance applicable to Participating Providers for Covered Services received from Other Providers.

• Out-of-Network Provider means a Hospital, Physician, Behavioral Health Practitioner, or Other Provider who has not entered into an agreement with BCBSTX (or other participating Blue Cross and/or Blue Shield Plan) as a managed care Provider.Out-of-Pocket Maximum means the cumulative dollar amount of Eligible Expenses, including the Calendar Year Deductible, incurred by a Participant during a Calendar Year.

• When you receive Covered Services from a Non-Participating Provider, you are responsible for:• the Copayment or Coinsurance (once any Calendar Year Deductible has been met), and• any charges above the Allowable Amount, or• any charges above the stated dollar amount, which is the Benefit maximum.

• Certain Covered Services may not be subject to the Calendar Year Deductible, as shown in your Schedule of Benefits.

• Any amounts you pay that count towards the medical Calendar Year Deductible also count towards the Calendar Year Out-of-Pocket Maximum.This Plan has a separate Participating Provider OOPM and Non-Participating Provider OOPM.Family coverage has an individual OOPM within the Family OOPM.

More Definitions of Calendar Year Deductible

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount a Member owes for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Contractholder and Covered Dependents. Third-party assistance toward Member’s share of the cost for Covered Services, including Specialty Medications, does not apply toward satisfaction of the Deductible.

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Covered Employee and Covered Dependents. Third-party Copayment assistance by a drug manufacturer or any other entity toward your cost-sharing for Covered Services including Specialty Medications, does not apply toward satisfaction of the Deductible.

Calendar Year Deductible means the out-of-pocket amount to be borne each Calendar Year by the Covered Person before dental expenses will be paid by the Plan. Such Deductible will be paid to the Dental Care Provider with respect to initial charges for services in each Calendar Year, and is separate from (in addition to) the Deductible for medical Benefits.