Spenddown Sample Clauses

Spenddown. Medical Assistance Recipients who otherwise meet all the enrollment requirements for SNBC are eligible to enroll in the MCO if they agree to pay their Spenddown as required on a monthly basis. The value of the first three (3) months of Spenddown obligation is deducted from the Capitation Payment.
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Spenddown. Medical Assistance Recipients who otherwise meet all the enrollment requirements for MnDHO are eligible to enroll in the MCO if they agree to pay their Spenddown as required on a monthly basis. Payment of the Spenddown obligation for the first month after enrollment is waived for the new Enrollee. The value of the first month Spenddown obligation will be deducted from the Capitation Payment.
Spenddown. The State and the Contractor agree that the capitated rates associated with this Contract reflect all costs associated with the medically needy aged and disabled (“spenddown”) populations net of shared cost. The enrollment process described below is consistent with the rate development methodology used.

Related to Spenddown

  • Orthodontics We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias. Procedures include but are not limited to: • Rapid Palatal Expansion (RPE); • Placement of component parts (e.g. brackets, bands); • Interceptive orthodontic treatment; • Comprehensive orthodontic treatment (during which orthodontic appliances are placed for active treatment and periodically adjusted); • Removable appliance therapy; and • Orthodontic retention (removal of appliances, construction and placement of retainers).

  • Fares and Travel Allowance 37.3 All Employees shall be entitled to receive the fares and travel allowance as follows:

  • Tuition The Charter School shall not charge tuition or fees to its students except as may be authorized for local boards pursuant to O.C.G.A. § 20-2-133.

  • Medical Exams 18.1: The Sheriff's Department may require a physical and/or psychological exam by a doctor, at the Employer's expense, to determine the employee's ability to perform his/her regular duties, if deemed appropriate. The employee may obtain a second opinion, at the employee's expense, and in the event there is a dispute between the Employer's doctor and the employee's doctor, both of these doctors shall select a third doctor, whose decision shall be final and binding on the parties. The expense for the third doctor's opinion shall be split 50-50 by the Employer and the employee if not covered by the employee's insurance.

  • Trips 6.5.6.1 Trip hours will be awarded weekly.

  • Prosthodontics We Cover prosthodontic services as follows: • Removable complete or partial dentures, for Members 15 years of age and above, including six (6) months follow-up care; • Additional services including insertion of identification slips, repairs, relines and rebases and treatment of cleft palate; and • Interim prosthesis for Members five (5) to 15 years of age. We do not Cover implants or implant related services. Fixed bridges are not Covered unless they are required: • For replacement of a single upper anterior (central/lateral incisor or cuspid) in a patient with an otherwise full complement of natural, functional and/or restored teeth; • For cleft palate stabilization; or • Due to the presence of any neurologic or physiologic condition that would preclude the placement of a removable prosthesis, as demonstrated by medical documentation.

  • Medical Flexible Spending Arrangement A. During January 2020 and again in January 2021, the Employer will make available two hundred fifty dollars ($250) in a medical flexible spending arrangement (FSA) account for each bargaining unit member represented by a Union in the Coalition described in RCW 41.80.020(3), who meets the criteria in Subsection 28.7(B) below.

  • FARES AND TRAVELLING ALLOWANCE (a) In lieu of the basic daily excess fares and travel pattern allowance prescribed by Xxxxxx

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services.

  • Wellness A. To support the statewide goal for a healthy and productive workforce, employees are encouraged to participate in a Well-Being Assessment survey. Employees will be granted work time and may use a state computer to complete the survey.

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