Covered benefit definition

Covered benefit or “benefit” means those health care services to which a covered person is entitled under the terms of a health benefit plan.

Covered benefit means that you can get this service through AHCCCS and Arizona Complete Health-Complete Care Plan. “Medically Necessary” means that a covered service is provided by a physician or other licensed practitioner of the healing arts within the scope of practice under state law to prevent disease, disability or other adverse health conditions or their progression, or prolong life.

Covered benefit means an enrollee’s entitlement to payment for or provision of health services as defined in an agreement with a health plan. Covered benefit shall have the same meaning as covered service.

Examples of Covered benefit in a sentence

• In order for Health Care Services to be covered under this Contract, such services must meet all of the requirements to be a Covered Benefit or Covered Service, including being Medically Necessary, as defined by AvMed.

• The Technology Assessment Committee evaluates new technologies and/or new applications of existing technologies, determines the value of the new technology, and recommends whether the technology should be a specified Covered Benefit of your Plan.

• Prior Authorization is a clinical evaluation process to determine if the requested Healthcare Service is Medically Necessary, a Covered Benefit, and if it is being delivered in the most appropriate healthcare setting.

• The charge for a Covered Benefit which is determined by the HMO to be the prevailing charge level made for the service or supply in the geographic area where it is furnished.

• For the purpose of coverage, HMO may determine whether any benefit provided under the Certificate is Medically Necessary, and HMO has the option to only authorize coverage for a Covered Benefit performed by a particular Provider.

More Definitions of Covered benefit

Covered benefit or “benefit” means those health care services to which a covered person

Covered benefit means each of (a) the Premium Conversion Benefit, (b) the Dependent Care Assistance Program, (c) the Health Flexible Spending Arrangement, and (d) the HSA Contribution Benefit. The rules regarding the Premium Conversion Benefit, the Dependent Care Assistance Program, the Health Flexible Spending Arrangement and the HSA Contribution Benefit are described in more detail in the Plan and this Summary. However, the rules regarding benefits coverage under the Oxy Welfare Plan (which underlies the Premium Conversion Benefit) are set forth in the separate governing documents of the Oxy Welfare Plan. You can obtain a copy of certain documents regarding the Oxy Welfare Plan upon written request to the OxyLink Employee Service Center (see contact information in Article XII).

Covered benefit means a health care service for which an enrollee is entitled to payment under the terms of a health care plan.

Covered benefit or "benefit" means those mental healthcare services or substance abuse services to which a covered person is entitled under the terms of a health benefit plan;

Covered benefit or "benefit" means the health care services to which a covered person is entitled under the terms of a health care insurance plan offered by a managed care organization.

Covered benefit means any benefit, eligible for reimbursement under the Premium Conversion Program, including contracts issued by Providers, and/or with the employer if the employer self-funds benefits under a plan.

Covered benefit means any employee welfare benefit designated in Schedule I attached hereto, which may be revised from time to time without amendment to the Plan.