Lifetime Benefit Maximum definition

Lifetime Benefit Maximum means the maximum amount of Covered Services that the PPO will cover during a Member’s lifetime under this Certificate, as set forth on the Schedule of Benefits. This could be expressed in dollars, number of days or number of services.
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Examples of Lifetime Benefit Maximum in a sentence

  • Your Lifetime Benefit Maximum is calculated by adding up the Charges for all orthodontic Services we covered under this rider or under any other EOC with the same group number printed on the EOC to which this rider is attached, and subtracting any Deductible, Copayments, and Coinsurance you paid for those Services.

  • For purposes of this rider, a Lifetime Benefit Maximum means we will not cover more than the amount shown in the “Orthodontic Services Rider Benefit Summary” for all covered Services during your lifetime.

  • Your Lifetime Benefit Maximum is calculated by adding up the Charges for all Services we covered and subtracting any Deductible, Copayments, and Coinsurance you paid for those Services.

  • For purposes of this rider, a Lifetime Benefit Maximum means we will not cover more than the amount shown in the “Orthodontic Services Rider Plan Benefit Summary” for all covered Services during your lifetime.

  • For purposes of this rider, a Lifetime Benefit Maximum means we will not cover more than the amount specified in the “Benefit Summary” for all covered Services during your lifetime.

  • The Plan covers reasonable and customary charges for needed medical care, services or supplies, as described below, for either an illness or injury that is non-occupational and received while the employee and his/her dependents are covered, up to the Lifetime Benefit Maximum.

  • Each subsequent course of treatment for a Member shall be subject to the Cost Sharing amounts as set forth on the Schedule of Benefits, as well as Benefit Limits and Lifetime Benefit Maximum amounts as set forth in Sections 3.16.2.2, 3.16.4.1, 3.16.4.2 and 3.16.4.3 (expressed as admissions, days and visits).

  • Any amounts for a Covered Service which are greater than the PPO’s then current Non-Preferred Provider Fee Schedule Amount (except with respect to costs associated with Emergency Services) or which exceed the Lifetime Benefit Maximum set forth on the Schedule of Benefits, or amounts for any Covered Service which are applied toward satisfaction of the Deductible, Copayment or Coinsurance amounts, or which exceed the specific Benefit Limits set forth on the Schedule of Benefits are NOT COVERED.

  • Your Lifetime Benefit Maximum is calculated by adding up the Charges for all Orthodontic Services we covered under this rider or under any other EOC with the same group number printed on the EOC to which this rider is attached and subtracting any Deductible, Copayments, and Coinsurance you paid for those Services.

  • Orthodontic Services Rider Benefit Summary Lifetime Benefit Maximum $3,000 You Pay Orthodontic Services 50% of Charges up to the Lifetime Benefit Maximum, and 100% of Charges thereafter.