Covered Charge definition
Covered Charge or “Expense” as used herein means those charges for any treatment, services, or supplies that are: a) for Network Providers, not in excess of the Preferred Allowance; b) for Non-Network Providers, not in excess of the Reasonable and Customary Expenses; c) not in excess of the charges that would have been made in the absence of this insurance except for institutions, controlled or owned by state and/or local governments, which provide services to indigent and non-indigent patients; and d) incurred while this Policy is in force as to the Insured Person except with respect to any expense payable under the Extension of Benefits Provision.
Covered Charge or “Covered Expense” means only the expense incurred, or portion of such expense determined to be allowable after application of the appropriate discount, if any, for medical care, services or supplies that:
Covered Charge means those Medically Necessary services or supplies that are covered under this Plan.
Examples of Covered Charge in a sentence
When a Medicare eligible chooses this Contract as his or her primary health plan, if he or she incurs a Covered Service and Supply or Covered Charge for which benefits are payable under both this Contract and Medicare, this Contract is considered primary.
Coinsurance This is the percentage of a Covered Charge that must be paid by a Covered Person.
Any part of a charge that does not qualify as a Covered Charge, will not be applied toward satisfaction of the Out-of-Pocket Maximum.
More Definitions of Covered Charge
Covered Charge means the Reasonable and Customary charge incurred for a service or supply which is performed or given under the direction of a Doctor for the Medically Necessary treatment of an Injury or Sickness. A Covered Charge is considered incurred on the date the treatment or service is rendered or the supply is furnished.
Covered Charge means the amount billed by a dentist for a covered procedure during the term of the Contract.
Covered Charge means those Medically Necessary treatments, services and supplies that are prescribed by an Approved Provider and actually incurred by the Participant during the Combined Benefit Period and subject to the Combined Benefit Amount Per Participant and Combined Benefit Amount Per Occurrence. A Covered Charge shall be deemed to have been incurred on the date the Medically Necessary treatment was rendered, a service given or a supply delivered. Pre-approved expenses for mileage, transportation, food and lodging will be included as Covered Charges. The determination of whether a treatment, service or supply is a Covered Charge will be made by the Claims Administrator.
Covered Charge or “covered expense” means only the expense incurred, or portion of such expense determined to be allowable after application of the appropriate discount, if any, by the In- Network or Out-of-Area Network, for medical care, services or supplies that:
Covered Charge means a charge incurred by a person that is covered, in full or in part, by a health plan.
Covered Charge means the necessary and reasonable expenses incurred by an Insured for a Medically Necessary out-patient Prescription Drug that: 1) requires a written prescription by a Prescriber; 2) is dispensed in the Insured’s name by a licensed pharmacist;