Coinsurance Maximum definition

Coinsurance Maximum means a specified dollar amount of Coinsurance Incurred by a Participant, as set forth in the Summary of Benefits, for covered services in a Benefit Period. (Refer to the Summary of Benefits for the period selected by the Plan.)
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Coinsurance Maximum means the maximum dollar amount in the form of Coinsurance that a Member will be required to pay in a given Benefit Period for Covered Services, as set forth on the Schedule of Benefits. The Coinsurance Maximum does not include the following:
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Coinsurance Maximum means the maximum amount to be paid by an Insured as Coinsurance for Covered Services per Calendar Year. Please refer to Attachment A Benefit Schedule, for specific information on how the Coinsurance Maximum for your Plan is determined. The following are not included in the Calendar Year Coinsurance Maximum:  any expenses for reductions in benefits resulting from Insured’s failure to comply with SHL’s Managed Care Program, including the inappropriate use of an emergency room facility for a condition which does not require Emergency Services;  any expenses for Covered Services in excess of the Eligible Medical Expenses; Copayments and Prescription Drug fees;  expenses for services not covered under this Plan; or  expenses in excess of the Calendar Year, lifetime, or per Illness maximum benefit shown in the Attachment A Benefit Schedule.
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Examples of Coinsurance Maximum in a sentence

  • This means that the Member will be financially responsible for the difference between the PPO’s Non-Preferred Provider Fee Schedule Amount and the Non-Preferred Provider’s billed charge, even if the Coinsurance Maximum has been reached.

  • As Described in Section 1.9, when using a Non-Preferred Provider, any costs that exceed the PPO’s Non- Preferred Provider Fee Schedule Amount are not included in the Coinsurance Maximum.

Related to Coinsurance Maximum

  • Deductible Amount means, with respect to any Insuring Agreement, the amount set forth under the heading “Deductible Amount” in Item 3 of the Declarations or in any Rider for such Insuring Agreement, applicable to each Single Loss covered by such Insuring Agreement.

  • Deductible has the meaning set forth in Section 11.1(e).

  • Maximum Limit means that number of issued Shares representing 10% of the total number of issued Shares as at the date of the passing of this Resolution (excluding any Shares which are held as treasury shares as at that date); and

  • Write-Down Amount means, for any Collection Period for any 180-day Receivable or Repossessed Receivable, the excess of (a) the Principal Balance plus accrued and unpaid interest of such Receivable as of the last day of the Collection Period during which such Receivable became a 180-day Receivable or Repossessed Receivable, as the case may be, over (b) the estimated realizable value of such Receivable, as determined by the Servicer in accordance with its normal servicing procedures for the related Collection Period, which amount may be adjusted to zero by the Servicer in accordance with its normal servicing procedures if such Receivable has ceased to be a 180-day Receivable as provided in the definition of “180-day Receivable.”