Preferred Allowance definition

Preferred Allowance means the amount a Preferred Provider will accept as payment in full for Covered Medical Expenses.

Preferred Allowance means the amount a Network Provider will accept as payment in full for Covered Charges.

Preferred Allowance means the amount a Preferred Provider will accept as payment in full for Covered Medical Expenses. "Out of Network" providers have not agreed to any

Examples of Preferred Allowance in a sentence

• Insureds are responsible for any amounts that exceed the benefits shown in the Schedule, up to the Preferred Allowance.

• In-Network Providers have agreed to accept a Preferred Allowance as payment in full.

• When a covered Maternity is incurred by a Plan Participant, the Company will pay the Preferred Allowance or Usual, Reasonable and Customary medical expenses in excess of the Coinsurance as stated in the Schedule of Benefits, Maternity.

• We will pay Preferred Allowance or Usual, Reasonable and Customary expenses as stated in the Schedule of Benefits.

• The advantage to using Preferred Providers is that these providers have agreed to accept a predetermined fee or Preferred Allowance as payment in full for their services.

• Payment is based on the Preferred Allowance unless otherwise indicated.Medically Necessary/Medical Necessity: We reserve the right to review claims and establish standards and criteria to determine if a Covered Service is Medically Necessary and/or Medically Appropriate.

• A contract “is not rendered ambiguous merely because a term is not defined; rather, the term must be interpreted in its usual, ordinary, and popular sense .

• Consequently, when Insured Persons use Preferred Providers, out-of-pocket expenses will be less because any applicable coinsurance will be based on a Preferred Allowance (PA).The Insured Person should be aware that Preferred Provider Hospitals might be staffed with Out-of-Network Providers.

• The network for this plan is Aetna Passport to Healthcare® Primary PPO.If you use an Aetna Passport provider, covered medical services are paid by the insurance company at 100% of the Preferred Allowance.

• Out-of-Network Providers may not balance bill for the amount in excess of the Preferred Allowance.

More Definitions of Preferred Allowance

Preferred Allowance means the amount a Preferred Provider will accept as payment in full for Covered Medical Expenses. “Out of Network” providers have not agreed to any prearranged fee schedules. You may incur significant out-of-pocket expenses with these providers. Charges in excess of the insurance payment are your responsibility. Regardless of the provider, you are responsible for the payment of your Deductible. You must satisfy your Deductible before benefits are paid. We will pay according to the benefit limits in the Schedule of Medical Expense Benefits.

Preferred Allowance means the amount a Network Provider will accept as payment in full for Eligible Expenses. Sickness means illness or disease which requires treatment by a Physician while covered by this Plan Document. All related conditions and recurrent symptoms of the same or a similar condition will be considered the same Sickness.

Preferred Allowance. ; means the amount a Preferred Provider will accept as payment in full for covered medical expenses. “Preferred Provider” means the Doctors, Hospitals and other health

Preferred Allowance means the amount a Network Provider will accept as payment in full for Eligible Expenses.

Preferred Allowance means the amount a Preferred Provider and In-Network Provider will accept as payment in full for Covered Medical Expenses.

Preferred Allowance means the amount a Preferred Provider will accept as payment in full for Covered Medical Expenses. “Out of Network” providers have not agreed to any prearranged fee schedules. Insureds may incur significant out- of-pocket expenses with these providers. Charges in excess of the insurance payment are the Insured's responsibility. Regardless of the provider, each Insured is responsible for the payment of their Deductible. The Deductible must be satisfied before benefits are paid. The Company will pay according to the benefit limits in the Schedule of Benefits.