Examples of Schedule of Benefits in a sentence
Please refer to your Schedule of Benefits for particular Covered Services that are subject to a Copayment or Coinsurance.
Please refer to your Schedule of Benefits for cost-sharing amounts for Prescription Medications ordered through mail services.
Pay any applicable Calendar Year Deductible and Copayment or Coinsurance (as well as the Brand Additional Charge if you or your Physician choose a Brand Medication when a Generic equivalent is available) shown in your Schedule of Benefits.
Mail-order Prescription Drug coverage includes up to a 90-day supply of a routine Maintenance Medication for the cost-sharing amount shown in your Schedule of Benefits.
Once the Family Calendar Year Out-of-Pocket Maximum amount shown in your Schedule of Benefits has been reached, we will pay for Covered Services received by Members of the Family during the remainder of that calendar year at 100% of the Allowed Amount or Maximum Allowable Payment.