Eligible Charges Sample Clauses
Eligible Charges. Shall be defined as the portion of charges made to a Covered Person for Covered Services rendered which are payable to the Provider under this Agreement. For a Participating Provider, the Eligible Charges shall be the reimbursement amounts agreed to between the Company and the Participating Provider. For a Non-Participating Provider, the Eligible Charges for covered medical Services rendered by a provider who is not a Participating Provider, shall be limited to the lesser of (a) the actual charge made by the provider, or (b) in the United States, the Medicare Participating Provider fees in the geographic area where the Service was rendered; or (c) in Asia, the fees most recently contracted by the Company at St. Luke's Medical Center, Manila, Philippines, or (d) elsewhere, the Medicare National Standard Fee. For a Non-Participating Provider, the Eligible Charges for covered dental Services shall be the lesser of (a) the actual charges made by the provider or (b) the usual customary and reasonable charge, as determined by the Company, for the dental Service in the geographic region in which that Service was rendered.
Eligible Charges. “Eligible Charges” apply when the cost of the item is Covered at least in part by one (1) or more of the plans that cover the Member. Notwithstanding the foregoing, in a coordination of benefits situation where WHP is the secondary plan, Eligible Charges will not include charges or expenses for health care services which are not Covered Services under this Agreement.
12.4.1 WHP will not cover any charges in excess of what an HMO or network Provider has agreed to accept as payment in full. Also, when an HMO or network plan is primary and the Covered Person does not use an HMO or network Provider, WHP will not consider as an allowable charge any charge that would have been Covered by the HMO or network plan had the Covered Person used the services of an HMO or network provider.
Eligible Charges. The following charges are eligible for reimbursement per each program:
(1) Tuition Reimbursement Program
Eligible Charges. This scholarship is applicable for the Spring 2014 tuition only. The student is responsible for the remaining tuition charges and fees.