Other medical coverage definition

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:
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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. 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 your plan, log onto the Aetna website xxx...
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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.
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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 may also affect whether Medicare is a primary or secondary payer.

  • While you are covered with BCBSAZ, tell us right away about any changes in the following:• Your eligibility for Arizona Health Care Cost Containment System (AHCCCS) coverage during the term of this contract• Your mailing address, phone number, or email address (if you have given it to us)• Other medical coverage that you add or lose, including any changes in benefits If you do not tell us about changes, correspondence from BCBSAZ may not reach you in a timely manner.


More Definitions of Other medical coverage

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:
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Related to Other medical coverage

  • Coverage or “Covering”) shall mean that the developing, making, using, offering for sale, promoting, selling or importing of a given compound, formulation or product would infringe a Valid Claim of an issued patent in the absence of a license under such Valid Claim. The determination of whether a compound, formulation or product is Covered by a particular Valid Claim shall be made on a country-by-country basis.

  • Lot coverage means the portion or percentage of the area of a lot upon which buildings are erected.

  • Continuation Coverage means the temporary continuation of PEBB benefits available to enrollees under the Consolidated Omnibus Budget Reconciliation Act (COBRA), 42 U.S.C. Secs. 300bb-1 through 300bb-8, the Uniformed Services Employment and Reemployment Rights Act (USERRA), 38 U.S.C. Secs. 4301 through 4335, or the public employees benefits board's policies.

  • Period of Coverage means the Plan Year, with the following exceptions: (a) for Employees who first become eligible to participate, it shall mean the portion of the Plan Year following the date on which participation commences, as described in Section 3.1; and (b) for Employees who terminate participation, it shall mean the portion of the Plan Year prior to the date on which participation terminates, as described in Section 3.2.

  • Health care coverage means any plan providing hospital, medical or surgical care coverage for

  • Medical malpractice insurance means insurance against legal liability incident to the practice and provision of a medical service other than the practice and provision of a dental service.

  • Medical care facility as used in this title, means any institution, place, building or agency, whether

  • Insurance Coverage Contractor shall, at Contractor’s sole expense, procure, maintain and keep in force for the duration of this Contract the following insurance conforming to the minimum requirements specified below. Unless specified herein or otherwise agreed to by the City, the required insurance shall be in effect prior to the commencement of work by Contractor and shall continue in force as appropriate until the latter of:

  • Insurance means (i) all insurance policies covering any or all of the Collateral (regardless of whether the Collateral Agent is the loss payee thereof) and (ii) any key man life insurance policies.

  • Period of Insurance means the period commencing from the retroactive date and terminating on the expiry date as shown in the Policy Schedule.

  • Durable medical equipment means equipment which:

  • group insurance means blanket insurance and franchise insurance and any other forms of group insurance.

  • Adult foster care facility means an adult foster care facility licensed under the adult foster care facility licensing act, 1979 PA 218, MCL 400.701 to 400.737.

  • Basic hospital cover means a hospital policy that includes the clinical categories that must be covered by a basic hospital product.

  • FHA Insurance means the Federal mortgage insurance authorized pursuant to Section 220, 221(d)(3), 221 (d)(4) or 223(f) of Title II of the National Housing Act of 1934, as amended.

  • Bronze hospital cover means a policy that covers hospital treatment in all the clinical categories required for a bronze policy.

  • Individual health insurance coverage means health insurance coverage offered to individuals in the

  • Co-insurance means the percentage of the usual, reasonable, customary, and fair market value expense that a covered person must pay.

  • Group health insurance coverage means in connection with a group health plan, health insurance

  • Medical cannabis means the same as that term is defined in Section 26-61a-102.

  • Medical cannabis pharmacy means the same as that term is defined in Section 26-61a-102.

  • Participating Durable Medical Equipment Provider means a Durable Medical Equipment Provider who has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Group long-term care insurance means a long-term care insurance policy which is delivered or issued for delivery in this State and issued to:

  • Medical equipment means equipment used in a patient care environment to support patient treatment and diagnosis.

  • Health insurance coverage means benefits consisting of medical care (provided directly, through

  • Medical examination means the preliminary assessment of a person by an authorized health worker or by a person under the direct supervision of the competent authority, to determine the person’s health status and potential public health risk to others, and may include the scrutiny of health documents, and a physical examination when justified by the circumstances of the individual case;