PRIVATE DUTY NURSING CARE Sample Clauses

PRIVATE DUTY NURSING CARE. Fees for a registered nurse (other than a relative of the Insured Person) for private care while convalescing at Your destination, immediately following a covered Emergency Hospi- talization, and when prescribed by the attending Physician and deemed medically neces- sary, up to a maximum of CAN $3,000 per Event and per Insured Person, subject to the Emergency Assistance’s approval.
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PRIVATE DUTY NURSING CARE. This Plan will cover the cost of services of a registered graduate nurse, registered nursing assistant, a certified nursing assistant, a certified nursing assistant, or a licensed practical nurse who is duly qualified and who is not related to you or a member of your family and who is not a resident in your home. The services must:  be provided in a Person Insured’s home, and such home is not an institution,  be made on the recommendation of a Physician,  commensurate with the nature and gravity of the Sickness or Injury, and  have prior approval by Empire Life. These services are payable up to the maximum shown on the Schedule of Benefits; however, no payment will be made for homemaking or companion duties. Diagnostic Laboratory Procedures Payment will be made for eligible Diagnostic Laboratory Procedures, ordered by a Physician, and provided by a private medical laboratory. These services are payable up to the maximum shown on the Schedule of Benefits. Eligible procedures are:  Blood Work,  Colonoscopy,  Computerized Axial Tomography (CAT scan),  Electrocardiogram (ECG),  Magnetic Resonance Imaging (MRI),  Positron Emission Tomography (PET),  Mammogram,  Testing of Urine and other bodily fluids and tissues,  Ultrasound. Allergy testing performed by a laboratory is excluded. Paramedical Practitioners This Plan will include coverage for various Paramedical Practitioners, provided the services are not completed by a relative. These services are payable up to the maximum shown on the Schedule of Benefits. Payment will be considered an eligible expense only when the maximum under any Government Health Insurance Plan has been reached, unless prohibited by law. Dental Benefits for Accidents This Plan will include coverage for the services of a dentist or oral surgeon to repair or replace sound natural teeth damaged as a result of a direct accidental blow to the mouth and not an object wittingly or unwittingly placed in the mouth, including the setting of a fractured or dislocated jaw; however, no payment will be made for services, supplies or treatment rendered for a full mouth reconstruction, for vertical dimension correction, or for correction of temporomandibular joint dysfunction. Payment will be made provided the services are rendered within 365 days of the accident and while you are insured for this benefit. Hearing Aids This Plan will include the cost of the purchase and repairs of (excluding batteries or routine maintenance of) hearing aids...
Sample 1
PRIVATE DUTY NURSING CARE. This Plan will cover the cost of services of a registered graduate nurse, registered nursing assistant, a certified nursing assistant, or a licensed practical nurse who is duly qualified and who is not related to you or a member of your family and who is not a resident in your home. The services must: • be provided in a Person Insured's home, and such home is not an institution, • be made on the recommendation of a Physician, and • commensurate with the nature and gravity of the Sickness or Injury. These services are payable up to the maximum shown on the Schedule of Benefits; however, no payment will be made for homemaking or companion duties. Hospital Outpatient Services This Plan will include coverage for hospital outpatient services which are not covered by the Government Health Insurance Plan and which are xxxxxxxx.xx your province of residence. Diagnostic Laboratory Procedures Payment will be made up to a maximum of $500 per Person Insured per Benefit Period for eligible Diagnostic Laboratory Procedures, ordered by a Physician, and provided by a private medical laboratory clinic. Eligible procedures are: • Blood Work, • Colonoscopy, • Computerized Axial Tomography (CAT scan), • Electrocardiogram (ECG), • Magnetic Resonance Imaging (MRI), • Mammogram, • Testing of Urine and other bodily fluids and tissues, • Ultrasound. Diagnostic investigations available in a Hospital and allergy testing performed by a laboratory are excluded. Payment for Diagnostic Laboratory Procedures will be considered an Eligible Expense only when the procedure is not eligible under the provincial Government Health Insurance Plan.
Sample 1

Related to PRIVATE DUTY NURSING CARE

  • Private Duty Nursing Services This plan covers private duty nursing services, received in your home when ordered by a physician, and performed by a certified home healthcare agency. This plan covers these services when the patient requires continuous skilled nursing observation and intervention.

  • Child Care A. Employees employed as of March 1 who meet the following criteria shall be eligible for a lump sum payment each year. Eligible employees may apply for this payment between March 1 and April 15 of each year. Payment shall be made within thirty (30) days of receipt of the completed application. Any application received after April 15 will be considered on a case by case basis and shall not be arbitrarily rejected.

  • Emergency Care If you need emergency care, call 911 or go to the nearest hospital emergency room. If you are traveling outside our service area and need urgent care, call the Customer Service number provided in the chart above or visit our website and use the “Find A Doctor” feature to find a BlueCard provider.

  • Family Care Employees may use vacation leave for care of family members as required by the Family Care Act, WAC 296-130.

  • Vision Care Effective July 1, 2000, the District shall provide all full-time employees and their dependents with Vision Service Plan (VSP) Plan C. This plan shall provide for a comprehensive exam and new lenses every 12 months, and new frames every 12 months. All other services will be pursuant to the standard VSP plan description, except that it will reimburse up to $50 for examinations by non-panel providers. There shall be a $10 annual deductible on materials only. In addition, the following vision plan enhancements shall take place effective July 1, 2000: $60 wholesale frame allowance; computer glasses; progressive lenses, tints, and UV coatings.

  • Fitness for Duty Examination A. In directing employees to undergo a fitness for duty examination, the Agency will observe applicable rules and regulations.

  • Emergency Care Services If you experience a medical emergency while traveling outside our service area, go to the nearest emergency or urgent care facility. When you receive Out-of-Area covered healthcare services outside our service area and the claim is processed through the BlueCard Program, the amount you pay for the Out-of-Area Covered healthcare services, if not a flat dollar copayment, is calculated based on the lower of: • the billed charges for your Out-of-Area covered healthcare services; or • the negotiated price that the Host Blue makes available to us. Often, this “negotiated price” will be a simple discount that reflects an actual price that the Host Blue pays to your healthcare provider. Sometimes, it is an estimated price that takes into account special arrangements with your healthcare provider or provider group that may include types of settlements, incentive payments and/or other credits or charges. Occasionally, it may be an average price, based on a discount that results in expected average savings for similar types of healthcare providers after taking into account the same types of transactions as with an estimated price. Estimated pricing and average pricing also take into account adjustments to correct for over- or underestimation of past pricing of claims, as noted above. However, such adjustments will not affect the price we have used for your claim because they will not be applied after a claim has already been paid. Negotiated (non–BlueCard Program) Arrangements With respect to one or more Host Blues, in certain instances, instead of using the BlueCard Program, we may process your claims for covered healthcare services through Negotiated Arrangements for National Accounts. The amount you pay for covered healthcare services under this arrangement will be calculated based on the negotiated price (refer to the description of negotiated price in the BlueCard® Program section above) made available to us by the Host Blue.

  • Urgent Care This plan covers services received at an urgent care center. For other services, such as surgery or diagnostic tests, the amount that you pay is based on the type of service being provided. See Summary of Medical Benefits for details. Follow-up care (such as suture removal or wound care) should be obtained from your primary care provider or specialist.

  • Medical Care The Parents must comply with the School Welfare Officer's recommendations which may include a reasonable decision to release the Pupil home or to his / her education guardian when s/he is unwell.

  • Newborn Care A newborn child will be covered from the moment of birth provided that the newborn child is eligible for coverage and properly enrolled. Covered Services will consist of coverage for injury or illness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities, premature birth and transportation costs to the nearest facility appropriately staffed and equipped to treat the newborn's Condition, when such transportation is Medically Necessary. Circumcisions are provided for up to one year from the date of birth.

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