Benefit Limits. Benefits are limited to the least expensive Medically Necessary Durable Medical Equipment, Medical Supply, Orthotic Device or Prosthetic adequate to meet the patient’s medical needs. Purchase or rental of any Medical Device is at the discretion of CareFirst BlueChoice. Benefits will be limited to the lower cost of purchase or rental, taking into account the length of time the Member requires, or is reasonably expected to require the equipment, and the durability of the equipment, etc. The purchase price or rental cost must be the least expensive of its type adequate to meet the medical needs of the Member. If the Member selects a deluxe version of the appliance, device, or equipment not determined by CareFirst BlueChoice to be Medically Necessary, CareFirst BlueChoice will pay an amount that does not exceed CareFirst’s payment for the basic device (minus any Member Copayment or Coinsurance) and the Member will be fully responsible for paying the remaining balance.
Benefit Limits. Benefits are limited to the least expensive Medically Necessary Durable Medical Equipment, Medical Supply, Orthotic Device or Prosthetic adequate to meet the patient’s medical needs. Purchase or rental of any Medical Device is at the discretion of CareFirst. Benefits will be limited to the lower cost of purchase or rental, taking into account the length of time the Member requires, or is reasonably expected to require the equipment, and the durability of the equipment, etc. The purchase price or rental cost must be the least expensive of its type adequate to meet the medical needs of the Member. If the Member selects a deluxe version of the appliance, device, or equipment not determined by CareFirst to be Medically Necessary, CareFirst will pay an amount that does not exceed CareFirst’s payment for the basic device (minus any Member Copayment or Coinsurance) and the Member will be fully responsible for paying the remaining balance.
Benefit Limits. Bargaining unit members are eligible to apply for disability insurance coverage on the first day of the month immediately following the completion of 520 hours of straight-time employment. Employees with less than five (5) years of service are eligible for long-term disability and/or short-term disability for a period of time equivalent to their months of service. Employees with five (5) years or more are eligible for long- term disability to age sixty-five (65) or for a maximum of ten (10) years, whichever is shorter. Short-term disability benefits commence after completion of a seven (7) calendar day waiting period. Effective October 1, 2005, short-term disability benefits commence after completion of a fourteen (14) calendar day waiting period. Eligible employees receive sixty (60%) percent of the employee's regular weekly wage rate up to a maximum of $530.00 per week, for up to twenty-six (26) weeks. Employees may be required to exhaust accumulated personal time prior to going without pay if the disability leave is also a qualified FMLA leave. However, upon request, the employee may reserve twenty-eight (28) personal time hours, or their then current amount of accumulated personal time, whichever is less. Accumulated personal and/or vacation time may be used at the request of the employee. Long-term disability benefits commence after twenty-six (26) weeks, or upon proper certification of a permanent disability, whichever comes first. Eligible employees receive a monthly allowance of sixty percent (60%) of the employee’s regular monthly wage rate up to a maximum of $2100.00 per month.
Benefit Limits. The Employer agrees to pay the monthly premiums for Optical benefits effective on the first day of the month immediately following the completion of 1040 hours of straight- time employment at no cost to the employee. Employees shall also have the option of electing such coverage on the first day of the month immediately following the completion of 520 hours of straight-time employment, provided said employees pay the premiums through payroll deduction, until eligible for Employer paid coverage. Benefits are available every twenty-four (24) months for employees, spouses and eligible dependents, ages 19-25. Dependents under age 19 are eligible for benefits every twelve (12) months. There is a $5.00 co-pay per person for examinations and a $7.50 co-pay per person for lenses, frames and/or contact lenses. Maximum payments to participating providers after co-pays: Examinations $45 New Contact lens fitting $90 Current Contact lens fitting $60 Single vision lenses $22.50 Frame allowance $125 Bifocal lenses $37.50 Contact lenses *Up to maximum Trifocal or progressive lenses $42.50 Laser correction *Up to maximum *The maximum aggregate payout for all of the above benefits is $250; every 24 months for adults and every 12 months for dependents under age 19.
Benefit Limits. Bargaining unit members are eligible for disability insurance benefits on the first day of the month immediately following the completion of 520 hours of straight- time employment. Employees with less than 10,400 straight-time hours of service (five years of service) are eligible for long-term disability and/or short-term disability for a period of time equivalent to their service time. Employees with 10,400 straight- time hours of service (five years of service) or more are eligible for long-term disability to age sixty-five (65) or for a maximum of ten (10) years, whichever is shorter. Short-term disability benefits commence after completion of a thirty (30) calendar day waiting period. Eligible employees receive sixty (60%) percent of the employee's regular weekly wage rate up to a maximum of $500.00 per week, for up to twenty-six (26) weeks. Effective as soon as possible after ratification the weekly maximum shall increase to $530.00. Effective January 1, 2005, the weekly maximum shall increase to $580.00. Employees with enough accumulated personal time must use it to cover the initial thirty (30) calendar day waiting period. However, upon request the employee may reserve twenty-eight
Benefit Limits. Benefit Limits for preventive services are set forth on the Schedule of Benefits.
Benefit Limits. Benefits will be limited to the lower cost of purchase or rental, taking into account the length of time the Member requires, or is reasonably expected to require the equipment, the durability of the equipment, etc. The purchase price or rental cost must be the least expensive of its type adequate to meet the medical needs of the Member. If the Member selects a deluxe version of the appliance, device, or equipment not determined by CareFirst to be Medically Necessary, CareFirst will pay an amount that does not exceed CareFirst's payment for the basic device (minus the Member Copayment) and the Member will be fully responsible for paying the remaining balance.
Benefit Limits. Bargaining unit members are eligible to apply for disability insurance benefits on the first day of the month immediately following the completion of 520 hours of straight-time employment. Employees with less than five (5) years of service are eligible for long-term disability and/or short-term disability for a period of time equivalent to their months of service. Employees with five (5) years or more are eligible for long- term disability to age sixty-five (65) or for a maximum of ten (10) years, whichever is shorter. Short-term disability benefits commence after completion of a seven (7) calendar day waiting period. Effective June 1, 2006, short-term disability benefits commence after completion of a fourteen (14) calendar day waiting period. Eligible employees receive sixty (60%) percent of the employee's regular weekly wage rate up to a maximum of $450.00 per week, for up to twenty-six (26) weeks. During the waiting period, employees may be required to exhaust accumulated personal time prior to going without pay. However, during the waiting period, upon request, the employee may reserve twenty-eight (28) personal time hours, or their then current amount of accumulated personal time, whichever is less. During the waiting period, accumulated personal and/or vacation time may be used at the request of the employee. Employees are not eligible to receive any other pay, including, but not limited to, holiday pay during the waiting period. Long-term disability benefits commence after twenty-six (26) weeks, or upon proper certification of a permanent disability, whichever comes first. Eligible employees receive a monthly allowance of sixty percent (60%) of the employee’s regular monthly wage rate up to a maximum of $1800.00 per month. Determination of eligibility and payment of benefits is a function of the insurance carrier. Employees are bound by the terms and conditions of the carrier.
Benefit Limits. Bargaining unit members are eligible to apply for disability insurance coverage on the first day of the month immediately following the completion of 520 hours of straight-time employment. Employees with less than five (5) years of service are eligible for long-term disability and/or short-term disability for a period of time equivalent to their months of service. Employees with five (5) years or more are eligible for long- term disability to age sixty-five (65) or for a maximum of ten (10) years, whichever is shorter. Short-term disability benefits commence after completion of a seven (7) calendar day waiting period. Effective December 1 short-term disability benefits commence after completion of a fourteen (14) calendar day waiting period. Eligible employees receive sixty (60%) percent of the employee's regular weekly wage rate up to a maximum of $580.00 per week, for up to twenty-six (26) weeks. Employees with enough accumulated personal time must use this time to cover the initial fourteen (14) calendar day waiting period. However, upon request, the employee may reserve twenty-eight (28) personal time hours, or their then current amount of accumulated personal time, whichever is less. If the employee has no personal time available, the employee may use accumulated vacation hours. Employees are not eligible to receive any other pay, including, but not limited to, holiday pay during the waiting period. Long-term disability benefits commence after twenty-six (26) weeks, or upon proper certification of a permanent disability, whichever comes first. Eligible employees receive a monthly allowance of sixty percent (60%) of the employee’s regular monthly wage rate up to a maximum of $2,400.00 per month.
Benefit Limits. Bargaining unit members are eligible to apply for disability insurance benefits on the first day of the month immediately following the completion of 520 hours of straight-time employment. Employees with less than five (5) years of service are eligible for long-term disability and/or short-term disability for a period of time equivalent to their months of service. Employees with five (5) years or more are eligible for long- term disability to age sixty-five (65) or for a maximum of ten (10) years, whichever is shorter. Short-term disability benefits will commence after completion of a twenty-one (21) day calendar day waiting period. Eligible employees receive sixty (60%) percent of the employee's regular weekly wage rate up to a maximum of $425.00 per week, for up to twenty-six (26) weeks. Employees will be required to exhaust accumulated personal and vacation time prior to going without pay if the disability leave is also a qualified FMLA leave. However, the employee may reserve up to twenty-eight (28) hours of personal time and up to forty (40) hours of vacation time by signing the approved form at the time of application. Employees are not eligible to receive any other pay, including, but not limited to, holiday pay during the waiting period. Long-term disability benefits commence after twenty-six (26) weeks, or upon proper certification of a permanent disability, whichever comes first. Eligible employees receive a monthly allowance of sixty percent (60%) of the employee’s regular monthly wage rate up to a maximum of $1800.00 per month.
