Special Coverage definition

Special Coverage. A component of Covered Services, described in Section 7.7 of this Contract, which are more extensive than the Basic Coverage services, and for which Enrollees are eligible only by “registering”; registration for Special Coverage is based on intensive medical needs occasioned by serious illness.
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Examples of Special Coverage in a sentence

  • In addition to the insurance provided by the Property Coverages, your policy provides these Special Coverage Features, subject to the terms and conditions set out.

  • The identification of these beneficiaries will allow rapid access of the medical services covered under our Special Coverage.

  • The INSURER shall expedite access to benefits of beneficiaries diagnosed with conditions under the Special Coverage.

  • There is no pending or threatened condemnation, requisition or taking proceeding, lawsuit, or administrative action relating to any Seller Owned Real Property or other matter which would adversely affect the use, occupancy or value thereof.

  • The INSURER shall be responsible to contract all the necessary health care services and participating providers to insure that all the benefits covered under the Basic, Dental and Special Coverage of the plan are rendered, through the INSURER's participating providers with the timeliness, amount, duration and scope as those services are rendered to non-enrolled Medicaid recipients within the area/region served.

  • The Uniform Guide for Special Coverage (Attachment 7 to this Contract) includes the procedures to follow for this condition.

  • The INSURER is responsible to have available all participating providers needed in order to render all the medically necessary services required to provide the beneficiaries with the benefits included in the Basic, Dental and Special Coverage of the contracted health insurance as specified in ADDENDUM I of this contract.

  • In the event of any dispute between the Contractor and the MBHO concerning whether a Covered Service provided in a hospital or other inpatient facility falls within the scope of Behavioral Health Services covered by the MBHO, or within the scope of other Basic and Special Coverage covered by the Contractor, the terms of ASES Normative Letter 04-0130, dated February 13, 2004 (Attachment 13 to this Contract), shall govern.

  • The INSURER shall be responsible to contract all the necessary health care services and participating providers to insure that all the benefits covered under the Basic, Dental and Special Coverage of the plan are rendered, through the INSURER's participating providers with the timeliness, amount, duration and scope as those services are rendered to non-Medicaid recipients within the area/region served.

  • The beneficiary shall have the right to choose the provider to be referred to from those participating providers within the HCO's network that are under contract with the INSURER's for benefits covered under the Basic and Special Coverage.

Related to Special Coverage

  • Insurance Coverage Contractor shall, at Contractor’s sole expense, procure, maintain and keep in force for the duration of this Contract the following insurance conforming to the minimum requirements specified below. Unless specified herein or otherwise agreed to by the City, the required insurance shall be in effect prior to the commencement of work by Contractor and shall continue in force as appropriate until the latter of:

  • Debt Service Coverage means that for every $1.00 of debt service required to be paid there must be $1.15 of Net Operating Income available. A worksheet for the calculation of Debt Service Coverage is found in the Report of Operations attached hereto as Exhibit "H" and incorporated herein by this reference.

  • Collateral Coverage Ratio means (i) the aggregate value of any relevant collateral security, including the pro rata value of any shared collateral, divided by (ii) the outstanding aggregate principal amount of the relevant debt.

  • Initial Covered Debt means the Corporation’s 6.25% Notes due 2036, CUSIP No. ▇▇▇▇▇▇▇▇▇.

  • Minimum Essential Coverage has the meaning given in the Affordable Care Act, 26 U.S.C. §5000A(f).