Pregnancy and Maternity Services Sample Clauses
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Pregnancy and Maternity Services. This plan covers physician services and the services of a licensed midwife for prenatal, delivery, and postpartum care. The first office visit to diagnose a pregnancy is not included in prenatal services. This plan covers hospital services for mother and newborn child for at least forty-eight
Pregnancy and Maternity Services. Pre-natal, delivery, and postpartum services. 0% - After deductible Not Covered
Pregnancy and Maternity Services. Amniocentesis or any other service when performed solely to determine gender. • Services related to surrogate parenting or the newborn child of the surrogate parent, when the surrogate is not a member of this plan.
Pregnancy and Maternity Services. Pre-natal, delivery, and postpartum services. 0% - After deductible Not Covered Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay
Pregnancy and Maternity Services. Amniocentesis or any other service when performed solely to determine gender. • Services related to surrogate parenting or the newborn child of the surrogate parent, when the surrogate is not a member of this plan. • Abortions for which federal funding is not allowed in accordance with the Affordable Care Act (ACA) section 1303(b)(1)(B)(i), namely all abortions except in the case of rape or incest, or for a pregnancy which places the woman in danger of death unless an abortion is performed.
Pregnancy and Maternity Services. Pre-natal, delivery, and postpartum services. 0% - After deductible 20% - After deductible Prescription drugs and diabetic equipment and supplies dispensed at a pharmacy. See Summary of Pharmacy Benefits for prescription drugs purchased at a retail, specialty, or mail order pharmacy. Prescription drugs dispensed and administered by a licensed health care provider (other than a pharmacist), and not purchased from a retail, specialty or mail order pharmacy: Injectable drugs* 0% - After deductible 20% - After deductible Infused drugs* 0% - After deductible 20% - After deductible Medications other than injected and infused drugs* Are included in the allowance for the medical service being rendered. Are included in the allowance for the medical service being rendered.
Pregnancy and Maternity Services. Pre-natal, deliverya,nd postpartum services. 0%- Afterdeductible 20%- Afterdeductible Prescription Drugs and Diabetic Equipment and Supplies Prescription drugs and diabetic equipment and supplies dispensed at a pharmacy. See Summary of Pharmacy Benefits for prescription drugs purchased at a retail, specialty, or mail ordperharmacy. Prescription drugs dispensed and administered by a licensed health careprovider(other than a pharmacist), an notpurchased from a retail, specialty or mail order pharmacy: Injectable drugs* 0%- Afterdeductible 20%- Afterdeductible Infused drugs* 0%- Afterdeductible 20%- Afterdeductible Medications other than injected and infused rugs* Are included in thaellowance for the medical service bein rendered. Are included in thaellowance for the medical service being rendered. Covered Benefits- See Covered Healthcare Services for additional benefit limits and details. NetworkProviders Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Prevention Care Services and Early Detection Services See Prevention and Early Detection Services section for details. 0% 20%- Afterdeductible Must be performed by a certified home health care agen 0%- Afterdeductible 20%- Afterdeductible Radiation Therapy/Chemotherapy Services Outpatient 0%- Afterdeductible 20%- Afterdeductible In a S K o\ ffiVce L F L D Q ¶ V 0%- Afterdeductible 20%- Afterdeductible Inpatient 0%- Afterdeductible 20%- Afterdeductible Outpatient 0%- Afterdeductible 20%- Afterdeductible Skilled Care in a Nursing Facility* Skilled or su-bacute care 0%- Afterdeductible 20%- Afterdeductible Outpatient hospitainl/ a S K \ WV KL ▇▇ ▇▇ DD 20%- Afterdeductible 40%- Afterdeductible Inpatient physiciasnervices 0%- Afterdeductible 20%- Afterdeductible Outpatient physiciasnervices 0%- Afterdeductible 20%- Afterdeductible In a S K o\ ffiVce L F L D Q ¶ V 0% 20%- Afterdeductible Telemedicine Services When rendered by a designatepdrovider. $25 Not Covered When rendered by anetworkprovider. $25 Not Covered Outpatien,tin a S K o\ ffiVce, uLrgenFt caLreceDnterQor ¶ free-standing laboratory: MRI*, MRA*, CAT scans*, CTA scans*, PET scans* nuclear medicine*. 0%- Afterdeductible 20%- Afterdeductible Sleep studies.* 0%- Afterdeductible 20%- Afterdeductible Diagnostic imaging and tests, other than the diagnosti imaging services listed above. $75 20%- Afterdeductible Lab and pathology services. $25 20%- Afterded...
Pregnancy and Maternity Services. Reimbursement shall equal the Global Fee *** as set forth in Section 7.07 above.
Pregnancy and Maternity Services. Pre-natal, delivery, and postpartum services. 0% - After deductible 20% - After deductible Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service or for certain services in the benefit category. Please see Preauthorization in Section 5 for more information. You Pay You Pay Prescription drugs and diabetic equipment and supplies purchased at a retail, specialty, or mail order pharmacy. See Summary of PharmacyBenefits See Summary of PharmacyBenefits Prescription drugs requiring administration by a licensed health care provider*: Prescription drugs other than infused drugs - includes but is not limited to: medications by injection or inhalation, as well as nasal, topical, or transdermal medications. 0% - After deductible 20% - After deductible Infused drugs 0% - After deductible 20% - After deductible
Pregnancy and Maternity Services. Amniocentesis or any other service when performed solely to determine gender. • Services related to surrogate parenting or the newborn child of the surrogate parent, when the surrogate is not a member of this plan. • Abortions for which federal funding is not allowed in accordance with the Affordable Care Act (ACA) section 1303(b)(1)(B)(i), namely all abortions except in the case of rape or incest, or for a pregnancy which places the woman in danger of death unless an abortion is performed. • Biological products for allergen immunotherapy and vaccinations. • Blood fractions. • Compound prescription drugs that are not made up of at least one legend drug. • Bulk powders and chemicals used in compound prescriptions that are not FDA approved, are not covered unless listed on our formulary. • Prescription drugs prescribed or dispensed outside of our dispensing guidelines. • Prescription drugs ordered or prescribed based solely on online questionnaires, telephonic interviews, surveys, emails, or any other marketing solicitation methods, whether alone or in combination. • Prescription drugs prescribed by a provider who has been identified as routinely writing prescriptions without an established provider/patient relationship for prescription drugs that raise safety concerns. • Prescription drugs that have not proven effective according to the FDA. • Prescription drugs used for cosmetic purposes. • Prescription drugs purchased from a non-designated pharmacy, if a pharmacy has been designated for you through the Designated Prescription Drug Prescribers and Pharmacies program. • Experimental prescription drugs including those placed on notice of opportunity hearing status by the Federal Drug Efficacy Study Implementation (DESI). • Prescription drugs provided to you that are not dispensed by a network pharmacy or covered under your medical plan. • Prescription drugs and diabetic equipment and supplies purchased at a non-network pharmacy unless indicated as covered in the Summary of Pharmacy Benefits. • Prescription drug related medical supplies except for diabetic, and some asthma related supplies, regardless of the reason prescribed, the intended use, or medical necessity. Examples include, but are not limited to, alcohol pads, bandages, wraps or pill holders. • Off-label use of prescription drugs except as described in Experimental or Investigational Services in Section 3; • Prescribed weight-loss drugs unless included as a covered healthcare service or provided th...