For Single Coverage Only definition

For Single Coverage Only. [Tier 2] In the case of single coverage, for a [Member], the [Tier 2] Maximum Out of Pocket is the annual maximum dollar amount that a [Member] must pay as per [Member] Cash Deductible plus Coinsurance and Copayments for all covered services and supplies in a [Calendar] [Plan] Year. [All per [Member] Cash Deductible plus Coinsurance and Copayments applied to the [Tier 1] per [Member] Maximum Out of Pocket also apply to this [Tier 2] per [Member] Maximum Out of Pocket.] Once the [Tier 2] per [Member] Maximum Out of Pocket has been met during a [Calendar] [Plan] Year, no further Deductible or Coinsurance or Copayments will be required for such [Member] for the rest of the [Calendar] [Plan] Year. For Other than Single Coverage: [Tier 1] In the case of coverage which is other than single coverage, for a [Member], the [Tier 1] per [Member] Maximum Out of Pocket is the annual maximum dollar amount that a [Member] must pay as [Tier 1] per Covered Family Cash Deductible plus Coinsurance and Copayments for all covered services and supplies in a [Calendar] [Plan] Year. Once the [Tier 1] per [Member] Maximum Out of Pocket has been met during a [Calendar] [Plan] Year, no further [Tier 1] Deductible or Coinsurance or Copayments will be required for such [Member] for the rest of the [Calendar] [Plan] Year. In the case of coverage which is other than single coverage, for a Covered Family, the [Tier 1] Maximum Out of Pocket is the annual maximum dollar amount that members of a covered family must pay as [Tier 1] per Covered Family Cash Deductible plus Coinsurance and Copayments for all covered services and supplies in a [Calendar] [Plan] Year. Once the [Tier 1] per Covered Family Maximum Out of Pocket has been met during a [Calendar] [Plan] Year, no further [Tier 1] Deductible or Coinsurance or Copayment will be required for [Members] of the covered family for the rest of the [Calendar] [Plan] Year. For Other than Single Coverage: [Tier 2] In the case of coverage which is other than single coverage, for a [Member], the [Tier 2] per [Member] Maximum Out of Pocket is the annual maximum dollar amount that a [Member] must pay as [Tier 2] per Covered Family Cash Deductible plus Coinsurance and Copayments for all covered services and supplies in a [Calendar] [Plan] Year. Once the [Tier 2] per [Member] Maximum Out of Pocket has been met during a [Calendar] [Plan] Year, no further [Tier 2] Deductible or Coinsurance or Copayments will be required for such [Member] for the rest of ...
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Examples of For Single Coverage Only in a sentence

  • For Single Coverage Only: [Tier 1] In the case of single coverage, for a [Member], the [Tier 1] Maximum Out of Pocket is the annual maximum dollar amount that a [Member] must pay as per [Member] Cash Deductible plus Coinsurance and Copayments for all covered services and supplies in a [Calendar] [Plan] Year.

  • For Single Coverage Only: [Tier 2] Each [Calendar] [Plan] Year, a [Member] must have Covered Charges that exceed the [Tier 2] per [Member] Cash Deductible before We pay any benefits to a [Member] for those charges.

  • For Single Coverage Only: [Tier 1] Each [Calendar] [Plan] Year, a [Member] must have Covered Charges that exceed the [Tier 1] per [Member] Cash Deductible before We pay any benefits to the [Member] for those charges.

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