Treatment of Infertility Sample Clauses

Treatment of Infertility. (Please refer to the Benefit Schedule for other benefit provisions which may apply.) This Policy provides benefits for Covered Expenses including services to diagnose and treat conditions resulting in infertility. Please note: treatment for Infertility, such as in vitro fertilization and other types of artificial or surgical means of conception and associated procedures and the related medications are not covered.
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Treatment of Infertility. Network Benefits 75% of the charges incurred. Deductible does not apply. Infertility drugs must be obtained from a designated vendor. Drugs for the treatment of infertility are subject to a $3,000 maximum benefit per calendar year. Non-Network Benefits 55% of the charges incurred, after you pay the deductible. Diabetic Supplies Purchased at a Pharmacy Network Benefits 75% of the charges incurred. Deductible does not apply. Non-Network Benefits 55% of the charges incurred, after you pay the deductible. Specialty Drugs that are Self-Administered Network Benefits $12 copayment and 100% thereafter per prescription for generic formulary drugs. $35 copayment and 100% thereafter per prescription for brand name formulary drugs. $50 copayment and 100% thereafter per prescription for non-formulary drugs. Deductible does not apply. For Network Benefits, specialty drugs are limited to drugs on the Specialty Drug List and must be obtained from a designated vendor. Non-Network Benefits 55% of the charges incurred, after you pay the deductible. In order for the Plan to better manage available manufacturer-funded copayment assistance, copayments for certain specialty medications may vary and be set to approximate the maximum of any available manufacturer- funded copayment assistance programs. However, in no case will true out-of-pocket costs to the Covered Person be greater than the maximum copayment/coinsurance shown in this Benefits Chart. Manufacturer- funded copayment assistance received by a Covered Person will not apply to the Covered Person’s annual deductible or out-of-pocket limit. Drugs for the Treatment of Growth Deficiency Network Benefits 75% of the charges incurred. Deductible does not apply. For Network Benefits, growth deficiency drugs are limited to drugs on the Specialty Drug List and must be obtained from a designated vendor. Non-Network Benefits 55% of the charges incurred, after you pay the deductible. Contraceptive Drugs Network Benefits Formulary contraceptives are covered at 100% of the charges incurred. Deductible does not apply. Non-Network Benefits 55% of the charges incurred, after you pay the deductible. Drugs for Breast Cancer Prevention (for women at high risk for breast cancer who have not yet been diagnosed with the disease) Network Benefits 100% of the charges incurred. Deductible does not apply. Non-Network Benefits 55% of the charges incurred, after you pay the deductible. Limitations: • Certain drugs may require prior authorization as ...

Related to Treatment of Infertility

  • Patients The Dentist shall accept Covered Persons as patients as reasonably permitted by the Dentist's patient load and appointment calendar. The Dentist will provide Covered Dental Services to Covered Persons on the same basis as to the Dentist's other patients (for example: scheduling, quality of service, and fee charges). The Dentist will be solely responsible to Covered Persons for dental advice and treatment; SDC will have no control over Dentist's practice or the dentist-patient relationship.

  • Treatment of Interest For Federal and State tax purposes (i) interest shall accrue at the Accrual Rate, and (ii) payments made pursuant to section 2 shall first be treated as interest, up to the amount of interest so accrued, then shall be treated as principal, until Purchaser has received, as principal, the entire Principal Amount, and then shall be treated as interest.

  • Inpatient In accordance with Rhode Island General Law §27-20-17.1, this agreement covers a minimum inpatient hospital stay of forty- eight (48) hours from the time of a vaginal delivery and ninety-six (96) hours from the time of a cesarean delivery: • If the delivery occurs in a hospital, the hospital length of stay for the mother or newborn child begins at the time of delivery (or in the case of multiple births, at the time of the last delivery). • If the delivery occurs outside a hospital, the hospital length of stay begins at the time the mother or newborn is admitted as a hospital in connection with childbirth. Any decision to shorten these stays shall be made by the attending physician in consultation with and upon agreement with you. In those instances where you and your infant participate in an early discharge, you will be eligible for: • up to two (2) home care visits by a skilled, specially trained registered nurse for you and/or your infant, (any additional visits must be reviewed for medical necessity); and • a pediatric office visit within twenty-four (24) hours after discharge. See Section 3.23 - Office Visits for coverage of home and office visits. We cover hospital services provided to you and your newborn child. Your newborn child is covered for services required to treat injury or sickness. This includes the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities as well as routine well-baby care.

  • MANAGEMENT OF EVALUATION OUTCOMES 12.1 The evaluation of the Employee’s performance will form the basis for rewarding outstanding performance or correcting unacceptable performance.

  • Surgery Services and Mastectomy Related Treatment This plan provides benefits for mastectomy surgery and mastectomy-related services in accordance with the Women’s Health and Cancer Rights Act of 1998 and Rhode Island General Law 27-20-29 et seq. For the member receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician, physician assistant, or an advance practice registered nurse and the patient, for: • all stages of reconstruction of the breast on which the mastectomy was performed; • surgery and reconstruction of the other breast to produce a symmetrical appearance; • prostheses; and • treatment of physical complications at all stages of the mastectomy, including lymphedema. See the Summary of Medical Benefits for the amount you pay.

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services.

  • Patient A patient is defined as those persons for whom the Physician shall provide Services, and who are signatories to, or listed on the documents attached as Appendix 1, and incorporated by reference, to this agreement.

  • Restricted Use By Outsourcers / Facilities Management, Service Bureaus or Other Third Parties Outsourcers, facilities management or service bureaus retained by Licensee shall have the right to use the Product to maintain Licensee’s business operations, including data processing, for the time period that they are engaged in such activities, provided that: 1) Licensee gives notice to Contractor of such party, site of intended use of the Product, and means of access; and 2) such party has executed, or agrees to execute, the Product manufacturer’s standard nondisclosure or restricted use agreement which executed agreement shall be accepted by the Contractor (“Non-Disclosure Agreement”); and 3) if such party is engaged in the business of facility management, outsourcing, service bureau or other services, such third party will maintain a logical or physical partition within its computer system so as to restrict use and access to the program to that portion solely dedicated to beneficial use for Licensee. In no event shall Licensee assume any liability for third party’s compliance with the terms of the Non-Disclosure Agreement, nor shall the Non-Disclosure Agreement create or impose any liabilities on the State or Licensee. Any third party with whom a Licensee has a relationship for a state function or business operation, shall have the temporary right to use Product (e.g., JAVA Applets), provided that such use shall be limited to the time period during which the third party is using the Product for the function or business activity.

  • Treatment of Investments 1. Each Contracting Party shall grant to investors of the other Contracting Party treatment no less favorable than that it grants, in like circumstances, to its own investors or to investors of a third party with respect to management, maintenance, use, sale, or other disposition of investments in its territory, whichever is more favourable.

  • Medically Necessary Services for the State plan services in Addendum VIII. B medically necessary has the meaning in Wis. Admin. Code DHS §101.03(96m): services (as defined under Wis. Stat. § 49.46

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