Surgical Coverage Clause Samples
The Surgical Coverage clause defines the extent to which surgical procedures are covered under an insurance policy or healthcare agreement. It typically outlines which types of surgeries are included, any exclusions or limitations, and the process for obtaining pre-authorization or reimbursement. For example, it may specify that only medically necessary surgeries performed by licensed professionals are covered, while elective or cosmetic procedures are excluded. The core function of this clause is to clearly delineate the insurer's or provider's obligations regarding surgical costs, thereby preventing misunderstandings and managing financial risk for both parties.
Surgical Coverage. The Welfare Plan will include Medical-Surgical coverage as required by the Medical Commission. An Extend- ed Health Benefit Plan with coverage as per the Pulp and Paper Industry brochure dated July including Vision Care coverage for employees and eligible dependents will also form part of this Labour Agreement. Effective July the co-insurance rate for hospitalization will be incorporated into the Extended Health Benefit coverage to a maximum of per day.
Surgical Coverage. The Welfare Plan will include Medical-Surgical coverage as required by the Medical Commission. An Extended Health Benefit Plan with coverage as per the Pulp and Paper Industry brochure dated July including Vision Care coverage for employees and eligible dependents will also form part of this Labour Agreement. Effective July the co-insurance rate for hospitalization will be incorporated into the Extended Health Benefit coverage to a maximum of per day. Effective May but less than or over “When in the opinion of the attending physician and attending specialist a medical procedure is required that is not available in and is one for which the Medical Services Plan of will accept financial responsibility, the cost of travel and accommodation to the limits specified below will be paid for by the Plan. Where the attending physician specifies that an attendant is required, the travel and accommodation expenses for such person will be paid to the limit specified. The maximum limit under any one claim will be the return economy airfare or equivalent for patient and attendant, plus accommodation expenses up to a maximum of Receipts will be required and forwarded on the claim form prescribed by the Carrier.” This benefit will not stack on top of or duplicate existing provisions under local Medical Travel Benefit or government plans.