Major Medical Benefit definition

Major Medical Benefit means that part of your medical scheme cover that is specific to the medical scheme Plan Option that you are on and covers you in the event that you are Hospitalised or are required to undergo Treatment or a Procedure;
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Examples of Major Medical Benefit in a sentence

  • Major Medical BenefitThe Major Medical Benefit is designed to assist you with payment of your medical bills.

  • The Major Medical Benefit portion of the plan is subject to a deductible of $25.00 per family, per calendar year.

  • If you are totally disabled when your Major Medical Benefit terminates, benefits for such disability will be payable, as long as you remain disabled, up to a maximum period of 365 days after termination.

  • Extension of the Major Medical Benefit will cease if the Policy should terminate.

  • The Major Medical Benefit covers only those expenses which are considered reasonable and customary for the service provided, in the area where the expenses are incurred, provided you are resident in Canada.

  • Day procedures listed in the Benefit Table (e.g. gastroscopy, colonoscopy) may be covered in full up to the Libcare Rate under the Major Medical Benefit.

  • The following Anesthesia Services provision is added to the Physician Benefit Section or Major Medical Benefit Section, depending on your Certificate or Policy, replacing any previous provision of the same name or under the name Anesthesia:Anesthesia Services—if administered at the same time as a covered surgical procedure in a Hospital or Ambulatory Surgical Facility or by a Physician other than the operating surgeon or by a CRNA.

  • The provision, which appears under the Other Covered Services section or Major Medical Benefit Section, depending on your Certificate or Policy, will read as noted below.

  • The Major Medical Benefit covers only those expenses which are considered reasonable and customary for the service provided, in the area where the expenses are incurred, provided you are resident in Canada, AND covered under a provincial health insurance program.

  • Exclusions and Limitations In addition to the Plan’s General Limitations, the Major Medical Benefit does not cover the following: A.

Related to Major Medical Benefit

  • Medical Benefits means the monthly fair market value of benefits provided to the Employee and the Employee’s dependents under the major medical, dental and vision benefit plans sponsored and maintained by the Company, at the level of coverage in effect for such persons immediately prior to the Employee’s termination of employment date. The “monthly fair market value” of such benefits shall be equal to the monthly cost as if such persons elected COBRA continuation coverage at such time at their own expense.

  • Gap medical benefits means the benefits (if any) payable in respect of medical expenses that are less than, greater than or equal to the schedule fee, provided always that the medical expenses relate to a professional service that:

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • Additional gap medical benefits means the benefits (if any) payable in respect of medical expenses that are more than the schedule fee and which otherwise meet the requirements of the fund’s no or known gap policy, provided always that the medical expenses relate to a professional service that:

  • Medical benefit plan means a plan established and maintained by a carrier, a voluntary employees' beneficiary association described in section 501(c)(9) of the internal revenue code of 1986, 26 USC 501, or by 1 or more public employers, that provides for the payment of medical benefits, including, but not limited to, hospital and physician services, prescription drugs, and related benefits, for public employees or elected public officials. Medical benefit plan does not include benefits provided to individuals retired from a public employer or a public employer's contributions to a fund used for the sole purpose of funding health care benefits that are available to a public employee or an elected public official only upon retirement or separation from service.

  • Pharmacy benefit manager means a person, business or other

  • Pharmacy benefits manager means a person that performs pharmacy benefits management.

  • Annual Benefit means an annual sum of fifty thousand dollars ($50,000) multiplied by the Applicable Percentage (defined below) and then reduced to the extent required: (i) under the other provisions of this Agreement; (ii) by reason of the lawful order of any regulatory agency or body having jurisdiction over the Employer; and (iii) in order for the Employer to properly comply with any and all applicable state and federal laws, including, but not limited to, income, employment and disability income tax laws (eg., FICA, FUTA, SDI).

  • Supplemental Benefit means the monthly benefit payable to the Executive under this Agreement.

  • Retirement Plans means the retirement income, supplemental executive retirement, excess benefits and retiree medical, life and similar benefit plans providing retirement perquisites, benefits and service credit for benefits at least as great in value in the aggregate as are payable thereunder prior to a Change in Control.

  • Pharmacy benefits management means the administration or management of prescription drug

  • material benefit means a benefit which may not be financial but has a monetary value;

  • Retirement Benefits means benefits paid by reference to reaching, or the expectation of reaching, retirement or, where they are supplementary to those benefits and provided on an ancillary basis, in the form of payments on death, disability, or cessation of employment or in the form of support payments or services in case of sickness, indigence or death. In order to facilitate financial security in retirement, these benefits may take the form of payments for life, payments made for a temporary period, a lump sum, or any combination thereof;

  • Retiree means any person who has begun accruing a retirement

  • Life insurance producer means any person licensed in this state as a resident or nonresident insurance producer who has received qualification or authority for life insurance coverage or a life line of coverage pursuant to chapter 522B.

  • Public benefit means making capital available, or facilitating the availability of capital, to businesses in this state that have 750 or fewer employees, the intent of which is to create or retain employment opportunities for residents of this state, stabilize or increase the tax base of this state, or support the redevelopment of facilities for use by small businesses.

  • Special benefit means a particular and distinct benefit over and above general benefits conferred on real property located in the district or to the public at large. General enhancement of property value does not constitute “special benefit.”

  • income-related employment and support allowance means an income-related allowance under Part 1 of the Welfare Reform Act 2007;

  • Employee Contribution means any contribution made to the Plan by or on behalf of a Participant that is included in the Participant's gross income in the year in which made and that is maintained under a separate account to which earnings and losses are allocated.

  • Annual Benefit Limit means the maximum amount of benefits paid by the Company to the Policy Holder in a Policy Year irrespective of whether any limits of any benefit items stated in the Benefit Schedule have been reached. The Annual Benefit Limit is counted afresh in a new Policy Year.

  • Plan Benefit means the benefit payable to a Participant as calculated in Article V.

  • Health benefits plan means a benefits plan which pays or

  • SERP has the meaning assigned thereto in Section 5(c) hereof.

  • Net Benefits Test means a calculation to determine whether the benefits of a reduction in price resulting from the dispatch of Economic Load Response exceeds the cost to other loads resulting from the billing unit effects of the load reduction, as specified in Operating Agreement, Schedule 1, section 3.3A.4 and the parallel provisions of Tariff, Attachment K-Appendix, section 3.3A.4.

  • Medicare benefit means the Medicare benefit payable within the meaning of Part II of the Health Insurance Act 1973 with respect to a professional service.

  • Normal Retirement Benefit means the benefit described in Section 2.1.