Allowable claim amount definition

Allowable claim amount means the amount paid by an insurer under the customer's health benefit plan.
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Allowable claim amount means the amount paid by an insurer under the
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Allowable claim amount means the amount the health carrier or pharmacy benefits
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Examples of Allowable claim amount in a sentence

  • You are required to pay for your covered Prescription Drugs according to the lesser of:  the Copayment;  the Allowable claim amount for the Prescription Drug; or  the amount You would pay for the Prescription Drug if You purchased the drug without using Your health coverage.

  • When a volunteer first mention ACTA on a LQDN IRC channel in 2008 the volunteer set up a Wiki page and began collecting background on the Agreement.

  • Wh e r e t h e Age n c y c h ooses t o a ccep t an a ssig n m e n t of t h e lo an o r co n ve yan ce of t i t le, t h e d a t e of loss will be t h e d a t e o n w h ic h t h e Age n c y a ccep t s a ssig n m e n t of t h e lo an o r co n- ve yan ce of t i t le.( c) Allowable claim amount.

  • You are required to pay for your covered Prescription Drugs according to the lesser of: the Copayment; the Allowable claim amount for the Prescription Drug; or the amount You would pay for the Prescription Drug if You purchased the drug without using Your health coverage.

  • Allowable claim amount" means the amount paid by an insurer under the[customer's] enrollee's health benefit plan.

  • The Claim must contain an itemized statement of expenses.You are required to pay for your covered Prescription Drugs according to the lesser of: the Copayment; the Allowable claim amount for the Prescription Drug; or the amount You would pay for the Prescription Drug if You purchased the drug without using Your health coverage.

Related to Allowable claim amount

  • Allowable Cost means a cost that complies with all legal requirements that apply to a particular federal education program, including statutes, regulations, guidance, applications, and approved grant awards.

  • Allowable Costs means the costs defined as allowable in 42 CFR, Chapter IV, Part 413, as amended to October 1, 2007, except for the purposes of calculating direct medical education costs, where only the reported costs of the interns and residents are allowed. Further, costs are allowable only to the extent that they relate to patient care; are reasonable, ordinary, and necessary; and are not in excess of what a prudent and cost-conscious buyer would pay for the given service or item.

  • Unallowable Costs has the same meaning as in 44 Ill. Admin. Code Part 7000.

  • Allowable Amount on any date, means:

  • Maximum Program Amount means Common Shares with an aggregate Sales Price of the lesser of (a) the number or dollar amount of Common Shares registered under the effective Registration Statement (defined below) pursuant to which the offering is being made, (b) the number of authorized but unissued Common Shares (less Common Shares issuable upon exercise, conversion or exchange of any outstanding securities of the Company or otherwise reserved from the Company’s authorized capital stock), (c) the number or dollar amount of Common Shares permitted to be sold under Form S-3 (including General Instruction I.B.6 thereof, if applicable), or (d) the number or dollar amount of Common Shares for which the Company has filed a Prospectus (defined below).

  • Allowable Expense means a necessary, reasonable and customary item of expense for health care, which is: • covered at least in part under one or more plans covering the person for whom the claim is made; and • incurred while this plan is in force. When a plan provides healthcare coverage in the form of services, the reasonable cash value of each service is considered as both an allowable expense and a benefit paid. Vision care services covered under other plans are not considered an allowable expense under this plan. PLAN means any of the following that provides benefits or services for medical, pharmacy, or dental care treatment. If separate contracts are used to provide coordinated coverage for members of a group, the separate contracts are considered parts of the same plan and there is no COB among those separate contracts.

  • Allowable Expenses means any necessary, reasonable and customary item of expense at least a portion of which is covered under at least one of the Health Benefit Plans covering the person for whom claim is made. When a Health Benefit Plan provides benefits in the form of coverage for services, the reasonable cash value of each service rendered shall be deemed to be both an Allowable Expense and a benefit paid.

  • REMIC II Principal Loss Allocation Amount With respect to any Distribution Date, an amount equal to (a) the product of (i) 50% of the aggregate Stated Principal Balance of the Mortgage Loans and REO Properties then outstanding and (ii) 1 minus a fraction, the numerator of which is two times the aggregate of the Uncertificated Balances of REMIC II Regular Interest A-1, REMIC II Regular Interest A-2A, REMIC II Regular Interest A-2B, REMIC II Regular Interest A-2C, REMIC II Regular Interest A-2D, REMIC II Regular Interest M-1, REMIC II Regular Interest M-2, REMIC II Regular Interest M-3, REMIC II Regular Interest M-4, REMIC II Regular Interest M-5, REMIC II Regular Interest M-6, REMIC II Regular Interest M-7, REMIC II Regular Interest M-8, REMIC II Regular Interest M-9, REMIC II Regular Interest M-10, REMIC II Regular Interest M-11 and the denominator of which is the aggregate of the Uncertificated Balances of REMIC II Regular Interest A-1, REMIC II Regular Interest A-2A, REMIC II Regular Interest A-2B, REMIC II Regular Interest A-2C, REMIC II Regular Interest A-2D, REMIC II Regular Interest M-1, REMIC II Regular Interest M-2, REMIC II Regular Interest M-3, REMIC II Regular Interest M-4, REMIC II Regular Interest M-5, REMIC II Regular Interest M-6, REMIC II Regular Interest M-7, REMIC II Regular Interest M-8, REMIC II Regular Interest M-9, REMIC II Regular Interest M-10, REMIC II Regular Interest M-11 and REMIC II Regular Interest ZZ.

  • Covered Debt Amount means, on any date, the sum of (x) all of the Revolving Credit Exposures of all Lenders on such date plus (y) the aggregate principal amount (including any increase in the aggregate principal amount resulting from payable-in-kind interest) of Other Covered Indebtedness outstanding on such date.

  • Principal Loss Amount With respect to each Payment Date, the sum of: (a) the aggregate amount of Credit Event Net Losses for all Credit Event Reference Obligations for the related Reporting Period; (b) the aggregate amount of court-approved principal reductions (“cramdowns”) on the Reference Obligations in the related Reporting Period; (c) subsequent losses on any Reference Obligation that became a Credit Event Reference Obligation on a prior Payment Date; and (d) amounts included in the second, fourth, seventh, eighth and tenth priorities set forth in Section 3.03(f) hereof.

  • Applied Realized Loss Amount With respect to any Distribution Date, the amount, if any, by which, the sum of (i) the Aggregate Certificate Principal Balance and (ii) the Class C Certificate Principal Balance after distributions of principal on such Distribution Date exceeds the aggregate Stated Principal Balance of the Mortgage Loans as of such Distribution Date.