Copayment amount definition

Copayment amount means the amount of covered services that must be paid by a covered person for each service that is subject to a copayment amount (as shown in the Schedule of Benefits), before benefits are payable for remaining covered services for that particular service under the contract of any cost sharing percentage. Cosmetic treatment means treatments, procedures, or services that change or improve appearance without significantly improving physiological function and without regard to any asserted improvement to the psychological consequences or socially avoidant behavior resulting from an injury, illness, or congenital anomaly. Cost sharing percentage means the percentage of covered services that is payable by us. Cost-sharing reductions means reductions in cost sharing for an eligible individual enrolled in a silver level plan in the Health Insurance Marketplace or for an individual who is an American Indian and/or Alaskan Native enrolled in a QHP in the Health Insurance Marketplace. Covered service or covered service expenses means services, supplies or treatment as described in this contract which are performed, prescribed, directed or authorized by a physician. To be a covered service the service, supply or treatment must be

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Copayment amount means the fixed dollar amount paid by the Participant for each Prescription Order dispensed or refilled at a Participating Pharmacy after the Calendar Year Deductible has been satisfied and until the Out-of-Pocket Maximum has been reached.

Copayment amount means the amount of covered services that must be paid by a covered person for each service that is subject to a copayment amount (as shown in the Schedule of Benefits), before benefits are payable for remaining covered services for that particular service under the contract of any cost sharing percentage. Cosmetic treatment means treatments, procedures, or services that change or improve appearance without significantly improving physiological function and without regard to any asserted improvement to the psychological consequences or socially avoidant behavior resulting from an injury, illness, or congenital anomaly. Cost sharing percentage means the percentage of covered services that is payable by us. Covered service or covered service expenses means services, supplies or treatment as described in this contract which are performed, prescribed, directed or authorized by a physician. To be a covered service the service, supply or treatment must be

Examples of Copayment amount in a sentence

• Your Cost Share includes any: • Deductible; • Copayment amount; and • Coinsurance amount.

• The Co-payment amount or Co-insurance percentage you pay for a Prescription Drug Product will not exceed the Usual and Customary Charge of the Prescription Drug Product.

• Refer to your Summary of Benefits and Coverage for your Cost Sharing (Deductible, Coinsurance and/or Copayment) amount.

• Refer to your Summary of Benefits and Coverage for your Cost Sharing (Deductible, Coinsurance, and/or Copayment) amount.

• While Your Coinsurance financial responsibility may also be collected by the Provider at the time services are performed, the Provider may choose to bill You for these services after they have submitted the claim to Us. Cost sharing for services with Copayments is the lesser of the Copayment amount or Negotiated Fee Rate.

• Additionally, certain Physician office visits may have a Copayment amount that is different than the one stated here.

• The Copayment amount shall not exceed 50% of the total cost of the services provided.

• The Copayment amount for a preferred Formulary prescription insulin drug or a Medically Necessary alternative will be Covered at an amount not to exceed a total of $25.00* per 30-day supply.

• If the Plan’s contracted rate for the prescription is less than the Subscriber’s Copayment amount, the Sub- ▇▇▇▇▇▇▇ is responsible for payment of the contracted rate only.

• The Copayment amount for a preferred Formulary prescription insulin drug or a Medically Necessary alternative will be Covered at an amount not to exceed a total of $25.00 per 30-day supply.

More Definitions of Copayment amount

Copayment amount means the amount required for most office visits and consultation charges only. If the services provided require a return visit on a different day, a new Copayment Amount will be required for any office visits and/or consultation charge. Eligible Expenses for other covered charges provided at the time of the office visit or consultation (e.g. lab or X-ray) will be subject to the Deductible and Coinsurance Amount. In the case of Copayment Amount in reference to the Prescription Drug Program, the fixed dollar amount paid by the Participant for each Prescription Order dispensed or refilled at a Participating Pharmacy.

Copayment amount means the dollar amount paid by you for each Prescription filled or refilled through a Participating Pharmacy or non‐Partic­ ipating Pharmacy. COVERED DRUGS. means any Legend Drug (except insulin, insulin ▇▇▇­ logs, insulin pens, and prescriptive and non‐prescriptive oral agents for controlling blood sugar levels, including disposable syringes and needles needed for self administration):

Copayment amount means the dollar amount paid by you for each Prescription Order filled or refilled through a Participating Pharmacy or non‐ Participating Pharmacy.