Copayment Maximum. Cost Shares set forth in this Rider do not apply toward the Copayment Maximum set forth in the Summary of Services and Cost Shares in your EOC to which this Rider is attached. The Rx Copayment and Rx Coinsurance set forth above will continue to apply even after the Copayment Maximum in your EOC has been met. This Outpatient Prescription Drug Rider is subject to all the terms and conditions of the Group Agreement and Group EOC to which this Rider is attached. This Rider does not change any of those terms and conditions, unless specifically stated in this Rider. This External Prosthetic and Orthotic Devices Rider (herein called “Rider”) is effective as of the date of your Group Agreement and Group Evidence of Coverage, and shall terminate as of the date your Group Agreement and Group Evidence of Coverage terminates. The following benefits, limitations, and exclusions for External Prosthetic and Orthotic Devices are hereby added to the Benefits Section of the Group Evidence of Coverage (herein referred to as the Group EOC), in consideration of the application and payment of the additional Premium for such Services.
Appears in 1 contract
Sources: Group Agreement
Copayment Maximum. Cost Shares set forth in this Rider do not apply toward the Copayment Maximum set forth in the Summary of Services and Cost Shares in your EOC to which this Rider is attached. The Rx Copayment and Rx Coinsurance set forth above will continue to apply even after the Copayment Maximum in your EOC has been met. This Outpatient Prescription Drug Rider is subject to all the terms and conditions of the Group Agreement and Group EOC Evidence of Coverage to which this Rider is attached. This Rider does not change any of those terms and conditions, unless specifically stated in this Rider. This External Prosthetic and Orthotic Devices Rider (herein called “Rider”) is effective as of the date of your Group Agreement and Group Evidence of Coverage, and shall terminate as of the date your Group Agreement and Group Evidence of Coverage terminates. The following benefits, limitations, and exclusions for External Prosthetic and Orthotic Devices are hereby added to the Benefits Section of the Group Evidence of Coverage (herein referred to as the Group EOC), in consideration of the application and payment of the additional Premium for such Servicesservices.
Appears in 1 contract
Sources: Group Agreement