Network Benefits definition

Network Benefits. Benefits available for Covered Health Services when provided by a Network Provider. Health Services provided by a non-Network Provider are considered Network Benefits when such Health Services are approved in advance by The Company or are Emergency Health Services. “Non-Emergency Hospitalization” – any Confinement which is not as a direct result of Emergency Health Services.
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Network Benefits means the benefits available under this Contract for services and supplies that are provided by a Network Provider.
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Network Benefits. The Member will receive Out-of-Network Benefits when he/she receives Covered Services from an Out-of-Network Healthcare Provider without a Referral.
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Examples of Network Benefits in a sentence

  • Network Benefits are determined based on the contracted fee for each Covered Dental Service.

  • Insured Persons generally are required to pay more to the provider than for Network Benefits.

  • Network Benefits - benefits available for Covered Dental Services when provided by a Dental Provider who is a Network Dentist.

  • In order for Covered Dental Services to be paid as Network Benefits, the Insured Person must obtain all Covered Dental Services directly from or through a Network Dental Provider.

  • Network Benefits 75% of the charges incurred, after you pay the deductible.

  • In order for Covered Dental Services to be paid as Network Benefits, the Insured must obtain all Covered Dental Services directly from or through a Network Dental Provider.

  • If the new Provider is not in the Preferred Care Network, Benefits will be processed at the Non-Network Benefit level and the Allowable Charge applicable to that Provider.

  • For plans that have a Network Benefit level, Network Benefits are available only if you receive Covered Health Care Services from Network providers.

  • If the new Provider is not in the HMOLA Network, Benefits will be processed at the Non-Network Benefit level and the Allowable Charge applicable to that Provider.

  • Such Dispensing Entities may include an outpatient pharmacy, specialty pharmacy, Home Health Agency provider, Hospital-affiliated pharmacy or hemophilia treatment center contracted pharmacy.If you/your provider are directed to a Designated Dispensing Entity and you/your provider choose not to get your Pharmaceutical Product from a Designated Dispensing Entity, Network Benefits are not available for that Pharmaceutical Product.Certain Pharmaceutical Products are subject to step therapy requirements.


More Definitions of Network Benefits

Network Benefits means the benefits that the Member(s) or the Beneficiary became entitled to according to the terms and conditions of this Agreement. - “Operations Instructions and Exceptions”: means the First Party's guidelines containing information clarifying rendering of services to دنب يف نيبملا ينعملا اهل :"ةكرررررررشلا" - .فارطلأا تاكرشلا اهب دصقي :"ءلامعلا/ليمعلا" - نايكلا وأ تائيهلا وأ تارررررررسررررررسؤملا وأ لولأا فرطلا عم درررقارررعتملا ينونارررقلا عتمتلل نيديفترررسملا وأ ءارررضعلأا حلارررصل .ةينيمأتلا ةيطغتلاب ةيقحأ اهب دررررصقي :"ةلماررررشلا ةيطغتلا" - نم ةدافتررررسلاا يف ديفتررررسملا وأ وررررضعلا هذره برجومب ةرمدرقملا ةريبطلا تارمدرخلا تاءاررنثتررررررسلاا تاررعارم عم ،ةرريقاررفتلاا .ةررقملا اهب دررررررصقي :"ةكبررررررشلا لخاد ايازملا" - وأ وررررررضعلا قح حبررررررصت يتلا ارريازملا كل ت طورررررررشو ماكحلأ اق فو دي فتررررررسملا .ةيقافتلاا :"تاءانثترررررسلااو ليغرررررشتلا تاميلعت" - يتلاو لولأا فرطلا تاهيجوت اهب دصقي ميدقتب ةلرررررصلا تاذ تامولعملا حرررررضوت تاءانثترررررسلااو ءارررررضعلأا ىلإ تامدخلا .اهيلع ةدراولا وأ ضرم يأ اهب دررصقي :"ةيبط ةلاح" - .ةباصإ وأ ةلع يأ اهب درررصقي "ديفترررسم" وأ "ورررضع" - اررخلا قيبطتلاررب لررجررررررسم صخررررررش لرمتحم ضيرم وأ ضيرمك ةك رررررررشلاب يتلاو ةرريوررررررضعلا ةررقاررطبل لررماررح وأ/و نم نيديفترررررسملا وأ ءارررررضعلأل ردرررررصت .ةكرشلا Members and the exceptions ةقاطب اهب دررررصقي :"ةيوررررضعلا ةقاطب" - related. اررهردرررررررصي دررق يتلا يبطلا ارتررررررشلاا - “Medical Condition”: means .ديفتسملل لولأا فرطلا any disease, illness or injury. - “Member" or “Beneficiary”; means the person registered in the company’s application as a patient or possible patient and/or holder of Membership Card which is issued for the Members and/or Beneficiaries by the Company.
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Related to Network Benefits

  • Public Benefits means the provision of benefits to the community by the Developer in the form and at the times specified in Schedule 3.

  • Health Benefits means health maintenance organization, insured or self-funded medical, dental, vision, prescription drug and behavioral health benefits.

  • Separation Benefits has the meaning accorded such term in Section 3.04.

  • Medical Benefits means the monthly fair market value of benefits provided to the Employee and the Employee’s dependents under the major medical, dental and vision benefit plans sponsored and maintained by the Company, at the level of coverage in effect for such persons immediately prior to the Employee’s termination of employment date. The “monthly fair market value” of such benefits shall be equal to the monthly cost as if such persons elected COBRA continuation coverage at such time at their own expense.

  • Gap medical benefits means the benefits (if any) payable in respect of medical expenses that are less than, greater than or equal to the schedule fee, provided always that the medical expenses relate to a professional service that:

  • Fringe benefits means the amount of:

  • superannuation benefits means pensions, gratuities and other allowances payable on resignation, retirement or death;

  • Bereavement Pay Benefits means the benefits as set out in Article II hereof.

  • Severance Benefits means the payment of severance compensation as provided in Section 3.3 herein.

  • Pharmacy benefits management means the administration or management of prescription drug

  • Compensation and Benefits Programs means all compensation and benefit plans, policies, and programs of the Debtors, and all amendments and modifications thereto, applicable to the Debtors’ employees, former employees, retirees, and non-employee directors and the employees, former employees and retirees of their subsidiaries, including all savings plans, retirement plans, health care plans, disability plans, and incentive plans, deferred compensation plans, and life, accidental death, and dismemberment insurance plans.

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

  • Retirement Benefits means benefits paid by reference to reaching, or the expectation of reaching, retirement or, where they are supplementary to those benefits and provided on an ancillary basis, in the form of payments on death, disability, or cessation of employment or in the form of support payments or services in case of sickness, indigence or death. In order to facilitate financial security in retirement, these benefits may take the form of payments for life, payments made for a temporary period, a lump sum, or any combination thereof;

  • Additional Benefits means those benefits in addition to the rights and remedies available under the Australian Consumer Law.

  • Termination Benefits means the benefits described in Section 4.1(b).

  • Essential Health Benefits means, under section 1302(b) of the Patient Protection and Affordable Care Act, those health benefits to include at least the following general categories and the items and services covered within the categories: ambulatory patient services; Emergency Services; hospitalization; maternity and newborn care; mental health and substance abuse disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.

  • Employment benefits means all benefits provided or made

  • relevant benefits means any pension, annuity, lump sum, gratuity or other like benefit given or to be given on retirement or death, or in anticipation of retirement.

  • Basic health plan services means that schedule of covered

  • Additional gap medical benefits means the benefits (if any) payable in respect of medical expenses that are more than the schedule fee and which otherwise meet the requirements of the fund’s no or known gap policy, provided always that the medical expenses relate to a professional service that:

  • Health benefits plan means a benefits plan which pays or

  • Resource Adequacy Benefits means the rights and privileges attached to the Facility that satisfy any entity’s resource adequacy obligations, as those obligations are set forth in any Resource Adequacy Rulings and shall include any local, zonal or otherwise locational attributes associated with the Facility.

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Welfare Benefits means the types of benefits described in Section 3(1) of ERISA (whether or not covered by ERISA).

  • Benefits means any treatment, facility, equipment, drug, device, supply or service that you receive reimbursement for under a plan. BLUECARD is a national program in which we and other Blue Cross and Blue Shield plans participate. See How BlueCard Providers Are Paid: Coverage for Services Provided Outside of the Service Area in Section 6 for details. BLUE DISTINCTION CENTERS are network providers who are recognized by the Blue Cross and Blue Shield Association for delivering high-quality, effective, cost-efficient specialty care.

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.