Copayment(s) definition

Copayment(s) means the charge that (a) a Pre-65 Plan Network Pharmacy may charge a Pre-65 Plan Participant at the time of the provision of Covered Prescription Drug Services pursuant to the Pre-65 Plan and HOP Option Selection Materials, or (b) a HOP Part D Plan Network Pharmacy may charge a HOP Part D Plan Participant at the time of the provision of Covered Prescription Drug Services pursuant to HOP Part D Plan and HOP Option Selection Materials, whether specified as a defined dollar amount, a percentage of eligible expenses, or otherwise.

Copayment(s) refers to any copayments, deductibles, and coinsurance which are specifically described as the financial responsibility of the Member for a Covered Service in the applicable Health Services Contract and/or Evidence of Coverage in effect as of the date of service. Any other amount which Group or Group Provider may seek to recover from Members for Covered Services constitutes a surcharge and is prohibited by both this Agreement and by the Xxxx-Xxxxx Act.

Copayment(s) means payments required of or permitted to be charged to members for Covered Services under the ADHS Manual or any future equivalent thereof, as same may be amended or replaced from time to time. Also means the amount an individual must pay for a service benefit.

Examples of Copayment(s) in a sentence

• Copayments for the cost difference between generic and brand name drugs do not count against this annual OOP maximum.

• The Deductible applies before any Copayments or Coinsurance are applied.

• Cost-Sharing: Amounts You must pay for Covered Services, expressed as Copayments, Deductibles and/or Coinsurance.

• Coinsurance does not include Copayments [or Cash Deductible].] [COMPLEX IMAGING SERVICES.

• Once the Cash Deductible is met, We pay benefits for other such [Tier 1] Covered Services and Supplies above the Cash Deductible incurred by that Member, less any applicable Coinsurance or Copayments, for the rest of that Calendar Year.

• Cost Sharing Obligations mean those financial payment obligations incurred by HHSC in satisfaction of the Deductibles, Coinsurance, and Co-payments for the Medicare Part A and Part B programs with respect to Dual Eligible Members.

• Members shall be required to pay applicable Copayments at the time of service.

• Once the Cash Deductible is met, We pay benefits for other such [Tier 1] Covered Services and Supplies above the Cash Deductible incurred by that Member, less any applicable Coinsurance or Copayments, for the rest of that [Calendar] [Plan] Year.

• You will be responsible for any Copayment(s) or Coinsur­ ance, if applicable.

• When You receive Covered Services from a Non-Participating Provider, in addition to the applicable Copayments, Deductible and Coinsurance described in the Schedule of Benefits section of this Contract, You must also pay the amount, if any, by which the Non-Participating Provider’s actual charge exceeds Our Allowed Amount.

More Definitions of Copayment(s)

Copayment(s) means payments which are the responsibility of a Member for the provision of certain Covered Services in accordance with the applicable Medicaid Plan.

Copayment(s) or “Coinsurance” shall mean those amounts collected from Plan Beneficiaries by the relevant pharmacy pursuant to NDPERS’ Benefit Plan Design as specified in its Benefit Specification Form, and if relevant, as amended in a Benefit Change Form. “Copayment” shall mean any flat amount that a Plan Beneficiary is required to pay. “Coinsurance” shall mean any percentage amount that a Plan Beneficiary is required to pay.