Covered Medical Expenses means reasonable charges which are: 1) not in excess of the maximum benefit amount payable per service as specified in the Schedule of Benefits; 2) made for services and supplies not excluded under the Certificate; 3) made for services and supplies which are a Medical Necessity; 4) made for services included in the Schedule of Benefits; and 5) in excess of the amount stated as a deductible, if any.
Covered Medical Expenses means reasonable charges which are usual and Customary, incurred for services and supplies for any sickness/illness or covered Accident to the Insured Person.
Covered Medical Expenses means the Reasonable and Customary charges for expenses ordered by a Physician and incurred by a covered person for Medically Necessary services and supplies required for the treatment of a non-occupational Accident or Sickness.
Examples of Covered Medical Expenses in a sentence
Donor costs that are directly related to organ removal are Covered Medical Expenses for which benefits are payable through the Insured organ recipient’s coverage under the Policy.
This section describes Covered Medical Expenses for which benefits are available.
Benefits are payable for Covered Medical Expenses (see Definitions) less any Deductible incurred by or for an Insured Person for loss due to Injury or Sickness subject to: a) the maximum amount for specific services as set forth in the Schedule of Benefits; and b) any Coinsurance or Copayment amounts set forth in the Schedule of Benefits or any benefit provision hereto.
However, if an Insured is Hospital Confined on the Termination Date from a covered Injury or Sickness for which benefits were paid before the Termination Date, Covered Medical Expenses for such Injury or Sickness will continue to be paid as long as the condition continues but not to exceed 90 days after the Termination Date.
In these situations, the Member may be liable for the difference between the amount that the non-participating healthcare provider bills and the payment Blue Cross and Blue Shield of Montana will make for the Covered Medical Expenses as set forth in this paragraph.
More Definitions of Covered Medical Expenses
Covered Medical Expenses means a Reasonable and Customary Charge for a Reasonable, Medically Necessary service, treatment or supply, meant to improve a condition or Covered Person’s health, which is eligible for coverage under this Plan. Covered Expenses will be determined based upon all other Plan provisions.
Covered Medical Expenses means expenses incurred by or on behalf of an Insured Person for medical treatment, services and supplies covered by the Policy for Injury due to an Accident while coverage is in effect. A Covered Expense is deemed to be incurred on the date such medical treatment, services and supplies that gave rise to the expense or charge was rendered or incurred.
Covered Medical Expenses means reasonable charges which are: 1) not in excess of Usual and Customary Charges; 2) not in excess of the maximum benefit amount payable per services as specified in the Schedule of Benefits; 3) made for services and supplies not excluded under this policy; 4) made for services and supplies which are Medical Necessity; 5) made for services included in the Schedule of Benefits; and 6) in excess of the amount stated as a Deductible, if any.
Covered Medical Expenses include charges which are usual, customary and reasonable for medically necessary service, (hospital, physicians, psychiatric, chiropractic and other required services and supplies). GROUP INSURANCE (cont.') Retirees under sixty-five (65) and their dependents will be covered by the Group Comprehensive Medical Insurance Plan, and the Company will pay the premium for Retirees and their dependents for the first year following retirement. After this first year, retirees and their dependents will be eligible to receive medical insurance benefits from the UNITIL Retiree Trust. Active employees and retirees sixty-five (65) years or over will be covered by a supplement to Medicare Plan paid for by the Company. The eligible dependents (age 65 or over) of these active employees and retirees sixty-five (65) or over will also be covered by the Supplemental to Medical Plan with full premium paid for by the Company. The Company will pay the premium for the retirees and their dependents for the first year following retirement. After this first year, retirees and their dependents will be eligible to receive medical insurance benefits from the UNITIL Retiree Trust. Group Dental Plan Group Dental Care Insurance is provided for employees and their eligible dependents and is briefly outlined as follows: Deductible There is one $25.00 deductible per person per Calendar Year with a maximum of $75.00 per family each calendar year. This deductible does not apply to Coverage I and IV benefits, but does apply to Coverage II and III benefits. Coverage I - Diagnostic and Preventative, 100% Payment. Diagnostic Initial Examination; Examinations to determine the required dental treatment two times in a calendar year; Full Mouth/Panorex X-Rays once in a three (3) year period; Bitewing X-Rays twice in a calendar year; X-Rays of individual teeth as necessary. Preventative Cleanings two (2) times in a calendar year; Fluoride - twice in a calendar year (age limit 19) Space Maintainers. Coverage II - Restorative, after deductible, 80% paid by insurance, 20% paid by patient.
Covered Medical Expenses means medical Expenses Incurred by or on behalf of a Covered Person that are attributable to the Covered Person's Injury, Illness, accident or condition for which there is or was a Responsible Third Party.
Covered Medical Expenses means (i) all medical and dental expenses incurred by Executive, Xxxxxx or Xxxxxxxxx, to the extent such expenses are not otherwise reimbursed or covered by insurance or Medicare, and (ii) premiums for medical and dental insurance paid by Executive, Xxxxxx or Alexander; provided that Tamara’s expenses shall be covered during the lifetime of Executive only if she is Executive’s wife at the time such expense is incurred, and after Executive’s death, only if she is Executive’s wife on the date of his death. Post-Employment Health Benefits shall be provided to Executive and Xxxxxx, (i) for five years after termination if Executive’s employment with the Corporation terminates on or before June 30, 2012, other than termination by the Corporation without cause as defined in Section 13.3 hereof, by Executive for good reason as defined in Section 13.4 hereof or by death or permanent disability, or (ii) for the lifetime of Executive and Xxxxxx if Executive’s employment with the Corporation terminates after June 30, 2012, or if it terminates earlier due to termination by the Corporation without cause, termination by Executive for good reason or by death or permanent disability. If clause (i) of such previous sentence is applicable, Post-Employment Health Benefits shall be provided to Alexander for the shorter of (X) the applicable period set forth in clause (i) of the previous sentence and (Y) until he reaches the age of 18, or while he remains a full-time student after the age of 18 but in no event past the age of 23 (the “Child Age-Coverage Limit”); and if clause (ii) of such previous sentence is applicable, Post-Employment Health Benefits for Alexander shall continue until the Child Age-Coverage Limit. Executive shall cooperate, and cause Xxxxxx and Xxxxxxxxx to cooperate, with the Corporation by submitting to such physical exams and completing such insurance application forms and other documents, by enrolling in Medicare and other available insurance programs, and by submitting appropriate claims for payment or reimbursement thereunder, all as the Corporation shall request from time to time. If Executive is employed by another entity after termination of employment by the Corporation, he will, to the extent requested by the Corporation, participate in such health insurance plans as are available through such other entity. Executive will pay all taxes required to be paid by him, Xxxxxx or Alexander, by reason of the payment by the Corporation of Post-Employment He...
Covered Medical Expenses means, subject to the Maximum Annual Benefit, the reasonable expenses for necessary medical care which: