Calendar Year Deductible definition

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable Calendar Year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each Calendar Year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Covered Employee and Covered Dependents.

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Calendar Year Deductible means the first dollar amount of your Part A and/or Part B charges incurred outside of the United States during a Calendar Year.

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount a Member owes for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Contractholder and Covered Dependents. Third-party assistance toward Member’s share of the cost for Covered Services, including Specialty Medications, does not apply toward satisfaction of the Deductible.

Examples of Calendar Year Deductible in a sentence

• Certain Covered Services may not be subject to the Calendar Year Deductible, as shown in your Schedule of Benefits.

• The maximum amount that any one Member in a family can contribute toward the Family Calendar Year Deductible is the Individual Calendar Year Deductible.

• Pay any applicable Calendar Year Deductible and Copayment or Coinsurance (as well as the Brand Additional Charge if you or your Physician choose a Brand Medication when a Generic equivalent is available) shown in your Schedule of Benefits.

• When you receive Covered Services from a Participating Provider, you are only responsible for the Copayment or Coinsurance, once any Calendar Year Deductible has been met.

• Subject to Section 12.10, only those expenses for Covered Services submitted on Claims to AvMed will be credited toward the Calendar Year Deductible, and only up to the applicable Allowed Amount or Maximum Allowable Payment.

• All applicable Calendar Year Deductible, Copayment or Coinsurance amounts must be satisfied before we will pay any portion of the cost for Covered Services.

• The Family Calendar Year Deductible, when applicable, may be satisfied by any combination of two or more family Members meeting the Family Deductible amount.

• Once the Family Calendar Year Deductible has been satisfied, no other Member in the family will have any additional Calendar Year Deductible responsibility for the remainder of that calendar year.

• If you use any third-party Copayment assistance (sometimes also referred to as a “copay card” or “copay coupon”) provided by a drug manufacturer or any other entity to pay any applicable Calendar Year Deductible, Copayment, or Coinsurance amounts for any Specialty Medications, you will not receive credit toward your Calendar Year Out-of-Pocket Maximum or Calendar Year Deductible for any such assistance you use.

• Once the Family Calendar Year Deductible has been satisfied, no other Member in the family will have any additional Calendar Year Deductible responsibility for the remainder of that Calendar Year.

More Definitions of Calendar Year Deductible

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Contractholder and Covered Dependents. Third-party Copayment assistance (sometimes also referred to as a “copay card” or “copay coupon”) provided by a drug manufacturer toward your cost-sharing for Covered Services including Specialty Medications, does not apply toward satisfaction of the Deductible.

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Contractholder and Covered Dependents. Third-party Copayment assistance by a drug manufacturer or any other entity toward your cost-sharing for Covered Services including Specialty Medications, does not apply toward satisfaction of the Deductible.

Calendar Year Deductible means the out-of-pocket amount to be borne each Calendar Year by the Covered Person before dental expenses will be paid by the Plan. Such Deductible will be paid to the Dental Care Provider with respect to initial charges for services in each Calendar Year, and is separate from (in addition to) the Deductible for medical Benefits.