Covered service definition

Covered service means a health care service provided to a

Covered service means a service as defined in the state plan or approved waiver, Minnesota Statutes, §256B.0625, et seq., and Minnesota Rules, Parts 9505.0170 through 9505.0475, and as applicable, Minnesota Statutes, §256S, and that is provided in accordance with the MCO’s Service Delivery Plan and the MCO Enrollee Handbook, as approved by the STATE.

Covered service means credited service acquired in a covered position.

Examples of Covered service in a sentence

• If the amount that is billed for Covered Services by the Plan Participant’s Provider is less than the amount that the Plan Administrator has set for the Covered Service, the billed amount is the Allowable Charge and the Plan Administrator’s payment will be based on the billed amount.

• Also, Participating Providers waive the difference between the actual billed charge for a Covered Service and the Allowable Charge, while Non-Participating Providers will not.

• These fee allowances are our “Allowable Charge” represents the maximum amount We will pay for a Covered Service.

• When a Plan Participant receives a dental diagnosis from a Participating Provider for a Covered Service under this Benefit Plan, the Plan Participant may choose to have the covered Benefit as designated by this dental Benefit Plan; or an alternate type, form, or quality of dental service which is of equal or greater price, provided the Plan Participant approves the alternate service in advance and in writing.

• This is because the amount that some providers charge for a Covered Service may be higher than the contracted fee that has been accepted by most Participating Providers.

More Definitions of Covered service

Covered service means Medically Necessary services or supplies provided in accordance with the terms of this Agreement other than Covered Dental Services or Covered Vision Services.

Covered service means a service for which benefits are provided under a health plan that provides coverage for vision care or eye care services or a limited benefit vision insurance plan.[PL 2015, c. 171, §1 (NEW); PL 2015, c. 171, §4 (AFF).]

Covered service means, with respect to dental or related services specified in a policy or plan that provides coverage for those services, a service provided by a dentist or at the direction of a dentist to an insured under the policy or an enrollee of the plan for which the policy or plan makes payment, administered consis- tently with policies traditionally governing covered services, or for which the policy or plan would make payment but for the application of contractual limitations of deductibles, copayments, coinsurance, waiting periods, annual maximums, lifetime maxi- mums applicable to the same course of treatment, frequency limi- tations, or alternative benefit payments.

Covered service means a dental service for which reimbursement is available under a covered individual’s dental insurance plan or health insurance plan or for which reimbursement would be available but for the application of contractual limitations such as deductibles, co-payments, coinsurance, waiting periods, annual or lifetime maximums, frequency limitations, alternative benefit payments, or other limitations.

Covered service. A service or supply specified in this Contract for which Benefits are available when rendered by a Provider. Crown – A tooth-shaped cap that is placed over a tooth to cover it and restore its shape and size, strength, and improve its appearance. When a crown is cemented into place, it fully encases the entire visible portion of a tooth that lies at and above the gum line. Deductible – The dollar amount, if shown in the Schedule of Dental Benefits, of Allowable Charges for Covered Services that each Member must pay within a Benefit Period before payments are made under this Contract. If shown in the Schedule of Benefits, the Deductible may be waived for certain services. Dental Care and Treatment – All procedures, treatment, and surgery considered to be within the scope of the practice of dentistry, which is defined as that practice in which a person:

Covered service means a service provided by a health care

Covered service or "Covered benefit" means those health care services to which a beneficiary is entitled under the terms of the health benefit plan.