Other medical coverage means any reimbursement for or recovery of any element of incurred covered charges available from any other source whatsoever whether through an insurance policy or other type of coverage, except gifts and donations, including but not limited to the following:
Other medical coverage means any reimbursement for or recovery of any element of incurred covered charges available from any other source whatsoever whether through an insurance policy or other type of coverage, except gifts and donations, including but not limited to the following: • Any group, blanket, individual, or franchise policy of accident, disability, health, or accident and sickness insurance. • Any arrangement of benefits for members of a group, whether insured or uninsured. • Any prepaid service arrangement such as Blue Cross or Blue Shield, individual or group practice plans or health maintenance organizations. • Any amount payable as a benefit for accidental bodily injury arising out of a motor vehicle accident to the extent such benefits are payable under the medical expense payment provision (or, by whatever terminology used to include such benefits mandated by law) of any motor vehicle insurance policy. • Any amounts payable for injuries related to your job to the extent that he or she actually received benefits under a Workers’ Compensation Law. • Social Security Disability Benefits, except that Other Medical Insurance shall not include any increase in Social Security Disability Benefits payable to you after you become disabled while insured hereunder. • Any benefits payable under any program provided or sponsored solely or primarily by any governmental agency or subdivision or through operation of law or regulation. HMO/PPO Provision – In the event that covered expenses are denied under a Health Maintenance Organization, Preferred Provider Organization (PPO) or other group medical plan the member has in force, and such denial is because care or treatment was received outside of the network’s geographic area, benefits will be payable under this coverage, provided the expense is a covered expense. IMPORTANT HEALTH CARE REFORM INFORMATION Some language changes in response to the federal Affordable Care Act (ACA) may not be included in the enclosed certificate of coverage. This may be because the language is still pending regulatory review and approval. However, please note that for new plans on or after January 1, 2014, and for non-grandfathered plans that renew on a date on or after January 1, 2014, Aetna is administering medical and outpatient prescription drug coverage in compliance with the following applicable components of the ACA. The following is a summary of the recent changes under the ACA. For details on any benefit maximums and the cost sharing under ...
Other medical coverage means, except for: gifts; donations; subrogation of any person’s right of recovery for personal injuries from a third person; or any individually underwritten and individually issued policy or subscription contract providing exclusively for accident and sickness benefits and for which the entire premium has been paid by the insured, a member of the insured’s family, or the insured’s guardian or conservator; any reimbursement for or recovery of any element of incurred covered charges available from any other source whatsoever whether through an insurance policy or other type of coverage, including but not limited to the following:
Examples of Other medical coverage in a sentence
Other medical coverage includes your enrollment in your spouse’s employer-sponsored medical coverage as well as in a spouse’s Health Care Flexible Spending Account (HCFSA).
Other medical coverage in effect at the same time as this Humana coverage (individual or other group coverage)?m N m YOther medical insurance carrier namePolicy #Other coverage type:m Employee / Individual only m Employee / Individual and spouse m Employee / Individual and child(ren) m FamilyEffective date _ _ / _ _ / _ _ _ _Term date _ _ / _ _ / _ _ _ _3.
In seeking a provider for any exchange and clearing house services, the RA’s should consider whether they can offer offsetting of collateral or margin payments with related exchanges.
Other (medical coverage, pension fund etc.)............................................................
More Definitions of Other medical coverage
Other medical coverage means any plan or policy that provides insurance, reimbursement, or service benefits for hospital, surgical, or medical expenses. This includes payment under group or individual insurance policies, automobile no-fault or medical pay, homeowner insurance medical pay, premises medical pay, nonprofit health service plans, health maintenance organization subscriber contracts, self-insured group plans, prepayment plans, and Medicare when the covered person is enrolled in Medicare. Other medical coverage will not include Medicaid.