Copayment/Deductible definition

Copayment/Deductible means a fixed dollar portion of the amount claimed for Covered Prescription Drug Services that is to be paid by Members pursuant to the Member’s Plan.
Sample 1
Copayment/Deductible means a fixed dollar portion of the amount claimed for Covered Prescription Drug Services that is to be paid by Member pursuant to Member’s Benefit Plan.
Sample 1

Examples of Copayment/Deductible in a sentence

  • The Brand Drug and Generic Drug Copayment/Deductible and Coinsurance will apply as indicated in the applicable Drug List and Benefit Plan for Employer.

  • Major Medical Co-payment/Deductible Cover Co-payment benefit covers co-payments or deductibles levied by the medical scheme for in-hospital admissions, listed out-patient procedures and CT, MRI and PET scans.

  • If you choose to occupy a private room, you are responsible for paying: (1) the daily difference between the semi-private and private room rates; and (2) your Copayment/Deductible and Coinsurance (if any).

  • In the event Employer wishes to implement Benefit Plan design changes including, but not limited to, implementation of Coinsurance or increase of Copayment/Deductible, the pricing in the BPA Addendum may no longer be applicable.

  • You should collect copayments at the time of service; however, to determine the exact member responsibility related to the benefit plan deductibles and coinsurance, if any, we recommend that you submit claims first and refer to the appropriate Explanation of Benefits (EOB) when billing members.Annual Copayment/Deductible Maximum (Commercial)Annual out-of-pocket maximum is the combined total of annual deductible (if any) and annual copayment maximum (if any), as shown on the member’s Schedule of Benefits.

  • Plan Sponsor will pay BCBSNC for Covered Prescription Drug Services dispensed by the Mail Service Pharmacy in an amount equal to the contracted rate for each Covered Prescription Drug Service dispensed, less the applicable Copayment/Deductible or Coinsurance amount.

  • In-NetworkOut-of-NetworkMember Responsibility:DeductibleCoinsurance or CopaymentDeductible CoinsuranceAmounts above the Allowable Charge*Health Plan Responsibility:Allowable Charge minus Member responsibilityAllowable Charge minus Member responsibilityProvider Responsibility:Amounts above the Allowable Charge * For a complete definition of Allowable Charge, please refer to the Definitions Section at the front of this Evidence of Coverage.

  • If covered under Employer Benefit Plan, notwithstanding anything to the contrary in Sections a and b above and elsewhere in the Agreement, Employer will reimburse Claim Administrator for Covered Prescription Drug Products and Services designated as Specialty Drugs under the Specialty Drug program, at the pricing set forth in the BPA Addendum, subject to the Copayment/Deductible and Coinsurance in the applicable Benefit Plan.

  • Don't forget the hazard of using non standard large jaws and even full wide soft jaws.

  • Without citing any authority, Intervenors make the peculiar argument that the referendum amounts to an alternative remedy R-CALF should have sought before filing suit.

Related to Copayment/Deductible

  • Copayment means that you pay a fixed amount each time you fill a prescription.

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

  • High Deductible Health Plan means a Health Plan as defined by 26 USC § 223(c)(2)(A) that also is a Qualified Health Plan.

  • Individual health insurance coverage means health insurance coverage offered to individuals in the

  • Fraud Coverage During the period prior to the first anniversary of the Cut-Off Date, 2.00% of the aggregate principal balance of the Mortgage Loans as of the Cut-Off Date (the "Initial Fraud Coverage"), reduced by Fraud Losses allocated to the Certificates since the Cut-Off Date; during the period from the first anniversary of the Cut-Off Date to (but not including) the fifth anniversary of the Cut-Off Date, the amount of the Fraud Coverage on the most recent previous anniversary of the Cut-Off Date (calculated in accordance with the second sentence of this paragraph) reduced by Fraud Losses allocated to the Certificates since such anniversary; and during the period on and after the fifth anniversary of the Cut-Off Date, zero. On each anniversary of the Cut-Off Date, the Fraud Coverage shall be reduced to the lesser of (i) on the first, second, third and fourth anniversaries of the Cut-Off Date, 1.00% of the aggregate principal balance of the Mortgage Loans as of the Due Date in the preceding month and (ii) the excess of the Initial Fraud Coverage over cumulative Fraud Losses allocated to the Certificates since the Cut-Off Date. The Fraud Coverage may be reduced upon written confirmation from the Rating Agencies that such reduction will not adversely affect the then current ratings assigned to the Certificates by the Rating Agencies.

  • Coverage means the types of persons to be eligible as the beneficiaries of the Scheme to health services provided under the Scheme, subject to the terms, conditions and limitations.

  • Group health insurance coverage means in connection with a group health plan, health insurance

  • Lot coverage means the portion or percentage of the area of a lot upon which buildings are erected.

  • Medical Expense means an expense incurred at the time a past member or his or her health reimbursement account dependent is furnished the medical care or service. To be considered a medical expense under this act, the expense shall meet all of the following conditions:

  • COBRA Coverage means continued medical and dental coverage under the Company’s benefit plans, as determined under section 4980B of the Code.

  • Health insurance coverage means benefits consisting of medical care (provided directly, through

  • Creditable coverage means, with respect to an individual, coverage of the individual provided under any of the following:

  • ' Compensation Insurance With respect to all operations performed, the Party shall carry workers’ compensation insurance in accordance with the laws of the State of Vermont. Vermont will accept an out-of-state employer's workers’ compensation coverage while operating in Vermont provided that the insurance carrier is licensed to write insurance in Vermont and an amendatory endorsement is added to the policy adding Vermont for coverage purposes. Otherwise, the party shall secure a Vermont workers’ compensation policy, if necessary to comply with Vermont law.

  • Liability Insurance means compulsory professional liability errors and omissions insurance required by a governing body;

  • Medical malpractice insurance means insurance against legal liability incident to the practice and provision of a medical service other than the practice and provision of a dental service.

  • group insurance means insurance, other than creditor’s group insurance and family insurance, whereby the lives of a number of persons are insured severally under a single contract between an insurer and an employer or other person; (“assurance collective”)

  • Paid sick leave – means paid leave under the Emergency Paid Sick Leave Act.

  • Density bonus means a floor area ratio bonus over the otherwise maximum allowable density permitted under the applicable zoning ordinance and land use elements of the general plan of a city, including a charter city, city and county, or county of:

  • Insurance Amount has the meaning set forth in Section 6.08(c).

  • 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.

  • Premium tax means a tax paid by insurance companies to provincial and territorial governments calculated as a percentage of gross premiums written.

  • Health insurance carrier or "carrier" means any entity subject to the insurance

  • Special Hazard Coverage The Special Hazard Coverage on the most recent anniversary of the Cut-Off Date (calculated in accordance with the second sentence of this paragraph) or, if prior to the first such anniversary, $4,725,230, in each case reduced by Special Hazard Losses allocated to the Certificates since the most recent anniversary of the Cut-Off Date (or, if prior to the first such anniversary, since the Cut-Off Date). On each anniversary of the Cut-Off Date, the Special Hazard Coverage shall be reduced, but not increased, to an amount equal to the lesser of (1) the greatest of (a) the aggregate principal balance of the Mortgage Loans located in the single California zip code area containing the largest aggregate principal balance of Mortgage Loans, (b) 1.0% of the aggregate unpaid principal balance of the Mortgage Loans and (c) twice the unpaid principal balance of the largest single Mortgage Loan, in each case calculated as of the Due Date in the immediately preceding month, and (2) $4,725,230, as reduced by the Special Hazard Losses allocated to the Certificates since the Cut-Off Date. The Special Hazard Coverage may be reduced upon written confirmation from the Rating Agencies that such reduction will not adversely affect the then current ratings assigned to the Certificates by the Rating Agencies.