Expanded benefit definition

Expanded benefit means a covered service of a prepaid health plan that either is not a Medicaid covered service, or is a Medicaid covered service furnished by a prepaid plan for which the plan receives no capitation payment.
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Examples of Expanded benefit in a sentence

  • If member chooses to utilize the First Health Expanded benefit, the member will be subject to the expanded network out-of-pocket costs such as deductible and coinsurance.

  • Expanded benefit costs are intended to be funded by individual MMA capitated plans, and are excluded from the medical costs used to set capitation rates.

  • Expanded benefit options (dental or vision) if not included in base plan shall be paid in full by the student upon enrollment.

  • Expanded benefit packages could include higher spending lim- its for durable medical equipment and coverage of home visiting and respite care; greater allowable numbers of occupational and physical therapy vis- its; and greater allowable numbers of inpatient and outpatient mental health and substance abuse ser- vices.

  • If member chooses to utilize the First Health Expanded benefit, the member will be subject to the expanded network out-of-pocket costs such asdeductible and coinsurance.

Related to Expanded benefit

  • Death Benefit means the insurance amount payable under the Certificate at death of the Insured, subject to all Certificate provisions dealing with changes in the amount of insurance and reductions or termination for age or retirement. It does not include any amount that is only payable in the event of Accidental Death.

  • Last Monthly Benefit means the gross Monthly Benefit payable to the Insured Employee immediately prior to death. Any reductions for Other Income Benefits, or for earnings the Insured Employee received for Partial Disability Employment, will not apply.

  • Benefit Commencement Date means, for any Participant or beneficiary, the date as of which the first benefit payment, including a single sum, from the Participant’s Account is due, other than pursuant to a withdrawal under Article VIII.

  • Net Benefit means the present value of the Covered Payments net of all federal, state, local, foreign income, employment and excise taxes.

  • Final compensation of a member means: