Validly covered means that the individual involved was covered and met all policy requirements regarding eligibility for coverage, as opposed to an individual who was covered without having met all such requirements.
Family Coverage means coverage for you and your eligible spouse and/or dependents under this Certificate. FREESTANDING FACILITY……means an Outpatient services facility that is not covered under a Hospital's written agreement with Blue Cross and Blue Shield and has its own billing number and written agreement with Blue Cross and Blue Shield to provide services to participants in the benefit program at the time services are rendered. Freestanding Facilities may also be referred to as Outpatient Freestanding Facilities. GROUP POLICY or POLICY.....means the agreement between Blue Cross and Blue Shield and the Group, any addenda, this Certificate, the Group’s application and the Plan, as appropriate, along with any exhibits, appendices, addenda and/or other required information and the individual application(s) of the persons covered under the benefit program. HABILITATIVE SERVICES....means Occupational Therapy, Physical Therapy, Speech Therapy, and other services prescribed by a Physician pursuant to a treatment plan to enhance the ability of a child to function with a Congenital, Genetic, or Early Acquired Disorder. These services may include Physical Therapy and Occupational Therapy, speech language pathology, and other services for a Covered Person with disabilities in a variety of Inpatient and/or Outpatient settings, with coverage as described in the Certificate. HEARING AID.....means any wearable non-disposable, non-experimental instrument or device designed to aid or compensate for impaired human hearing and any parts, attachments, or accessories for the instrument or device, including an ear mold. HEARING CARE PROFESSIONAL. means a person who is a licensed Hearing Aid dispenser, licensed audiologist, or licensed physician operating within the scope of such license. HOME INFUSION THERAPY PROVIDER. means a duly licensed home infusion therapy provider, when operating within the scope of such license. PARTICIPATING HOME INFUSION THERAPY PROVIDER… means a Home Infusion Therapy Provider who has a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide Covered Services to participants in the benefit program at the time Covered Services are rendered. NON-PARTICIPATING HOME INFUSION THERAPY PROVIDER… means a Home Infusion Therapy Provider who does not have a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide Covered Services to participants in the benefit program at the time Covered Services are rendered. HOSPICE CARE PROGRAM PROVIDER.....means an organization duly licensed to provide Hospice Care Program Service, when operating within the scope of such license. PARTICIPATING HOSPICE CARE PROGRAM PROVIDER… means a Hospice Care Program Provider that either: (i) has a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide Covered Services to participants in the benefit program, or; (ii) a Hospice Care Program Provider that has been designated by any Blue Cross and/or Blue Shield Plan as a Participating Provider in the benefit program. NON-PARTICIPATING HOSPICE CARE PROGRAM PROVIDER… means a Hospice Care Program Provider that either:
QFC has the meaning assigned to the term “qualified financial contract” in, and shall be interpreted in accordance with, 12 U.S.C. 5390(c)(8)(D).
Child or covered child means a child (natural, step-child, legally adopted or a minor or disabled child who is dependent on the insured for support and maintenance) who is born to or brought to a marriage or to a civil union established according to Vermont law.
Boiler means an enclosed fossil or other fuel-fired combustion device used to produce heat and to transfer heat to recirculating water, steam, or other medium.