Well Child Care Sample Clauses

Well Child Care. With respect to infants, children, and adolescents, evidence-informed preventive care and screenings provided for in the comprehensive guidelines supported by the Health Resources and Services Administration.
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Well Child Care. Charges incurred by a Covered Person from newborn to seventeen (17) years of age for services rendered solely for the purpose of health maintenance and not for the Treatment of an Illness or Injury. Payment, for such Services shall be based on the Bright Futures/American Academy of Pediatrics recommendations for Preventive Pediatric health Care and as stated in Exhibit . Benefits for such services may include immunization and lab tests. Services must be performed by or under the supervision of a Physician. Well Child Care will not be subject to the deductible, and shall be covered at 100% by the Company. Any such care that is PPACA Preventive Care Services shall be covered without Deductibles, Co-Payments or Co-Insurance if received from a Participating Provider. Charges for treatment of illness or injury shall be covered as regular benefits. If the care is PPACA Preventive Care Services, requirements of this agreement and PPACA regulations shall be followed in determining the portion of any combined visit or service that is to be provided without Deductibles, Co-Payments or Co- Insurance
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Well Child Care. Well Child Care is covered only as set forth in §2.7 and as required by PPACA (as a PPACA Preventive Care Services or otherwise).
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Well Child Care. 7 exams from birth to 1 year 7 exams 1 through 5 years of age 1 exam every year from 5 through 11 years 1 exam every year from 11 through 22 years 1 exam every year 22+ No Copayment Deductible & Coinsurance Adult Physical Examinations Periodic, routine health examinations 1 exam every year 22+ No Copayment Deductible & Coinsurance Routine Gynecological Visit 1 visit per Calendar Year including pap smear No Copayment Deductible & Coinsurance Mammography One baseline screening for female 35 through 39 years of age One screening mammogram every Calendar Year for female 40 and older Note: or more frequently if recommended by the woman’s Physician (M.D.) No Charge Deductible & Coinsurance Vision Exams 1 vision exam and refraction every Calendar Year No Copayment Deductible & Coinsurance Hearing Exams 1 hearing exam every 2 Calendar Years No Copayment Deductible & Coinsurance Immunizations and Vaccinations includes those needed for travel No Copayment Deductible & Coinsurance APPENDIX B BLOOMFIELD PPO BENEFIT PLAN DESCRIPTION MEDICAL CARE Medical Office Visit Primary care office visits Specialist consultations OB/GYN care $20 Copayment Deductible & Coinsurance Maternity Care Initial visit subject to Copayment, no charge thereafter $20 Copayment Deductible & Coinsurance Allergy Office Visit/Testing Allergy Injections Immunotherapy or other therapy treatments Up to a maximum of 80 visits over a 3 Calendar Year period $20 Copayment No Copayment for Allergy Injection Deductible & Coinsurance Deductible & Coinsurance Diagnostic, Laboratory and X-ray Services No Charge Deductible & Coinsurance High Cost Diagnostic Tests MRI, MRA, CAT, CTA, PET and SPECT scans No Charge Deductible & Coinsurance HOSPITAL CARE – Prior authorization required All Inpatient Admissions Semi-private room Maternity and newborn care $200 Copayment Copayment is waived if readmitted within 30 days for same diagnosis Deductible & Coinsurance Skilled Nursing Facility up to 120 days per Calendar Year $200 Copayment Copayment is waived if admitted within 3 days of hospital discharge Deductible & Coinsurance Specialty Hospital (Rehabilitation) 60 days per Covered Person per Calendar Year $200 Copayment Deductible & Coinsurance Outpatient Surgery In a licensed ambulatory surgical center (including colonoscopy) No Copayment Deductible & Coinsurance EMERGENCY CARE Walk-in centers $20 Copayment Deductible & Coinsurance Urgent care – at participating centers $75 Copayment Paid as an In-Network Service Emer...
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Well Child Care. We will provide benefits for Well Child Care for covered children from the date of birth through attainment of age 19, when provided by your PCP. Well Child Care means an initial newborn check- up in the hospital and well child visits. Well child visits include a medical history, a complete physical examination, developmental assessment, anticipatory guidance, and laboratory tests ordered at the time of the visit. Such laboratory tests must be performed in the office or in a clinical laboratory. All well child visits must be provided in accordance with the standards and frequency schedule of the American Academy of Pediatrics. Well Child Care also includes immunizations against diphtheria, pertussis, tetanus, polio, measles, rubella, mumps, hemophilus influenza type B, and hepatitis B, and other necessary immunizations.
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Well Child Care. Charges for Well Child care for a Dependent child shall be paid in accordance with Affordable Care Act requirements.
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Related to Well Child Care

  • Child Care A. Employees employed as of March 1 who meet the following criteria shall be eligible for a lump sum payment each year. Eligible employees may apply for this payment between March 1 and April 15 of each year. Payment shall be made within thirty (30) days of receipt of the completed application. Any application received after April 15 will be considered on a case by case basis and shall not be arbitrarily rejected.

  • Primary Care Clinic Employees and each of their covered dependents must individually elect a primary care clinic within the network of providers offered by the plan administrator chosen by the employee. Employees and their dependents may elect to change clinics within their clinic’s Benefit Level as often as the plan administrator permits and as outlined above.

  • Newborn Care A newborn child will be covered from the moment of birth provided that the newborn child is eligible for coverage and properly enrolled. Covered Services will consist of coverage for injury or illness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities, premature birth and transportation costs to the nearest facility appropriately staffed and equipped to treat the newborn's Condition, when such transportation is Medically Necessary. Circumcisions are provided for up to one year from the date of birth.

  • Health and Safety Standards Contractor shall abide by all health and safety standards set forth by the State of California and/or the County of Xxxxxx pursuant to the Injury and Illness Prevention Program. If applicable, Contractor must receive all health and safety information and training from County.

  • Information Technology Accessibility Standards Any information technology related products or services purchased, used or maintained through this Grant must be compatible with the principles and goals contained in the Electronic and Information Technology Accessibility Standards adopted by the Architectural and Transportation Barriers Compliance Board under Section 508 of the federal Rehabilitation Act of 1973 (29 U.S.C. §794d), as amended. The federal Electronic and Information Technology Accessibility Standards can be found at: xxxx://xxx.xxxxxx-xxxxx.xxx/508.htm.

  • COUNTY’S QUALITY ASSURANCE PLAN The County or its agent will evaluate the Contractor’s performance under this Contract on not less than an annual basis. Such evaluation will include assessing the Contractor’s compliance with all Contract terms and conditions and performance standards. Contractor deficiencies which the County determines are severe or continuing and that may place performance of the Contract in jeopardy if not corrected will be reported to the Board of Supervisors. The report will include improvement/corrective action measures taken by the County and the Contractor. If improvement does not occur consistent with the corrective action measures, the County may terminate this Contract or impose other penalties as specified in this Contract.

  • Quality Assurance Plan The contractor shall develop and submit to NMFS a contractor Quality Assurance Plan, as referenced in Section F.5.3, which details how the contractor will ensure effectiveness and efficiency of collection efforts as well as the quality of data collected by its At-Sea Monitors. The contractor shall further establish, implement, and maintain a Quality Assurance Management program to ensure consistent quality of all work products and services performed under this contract.

  • Family Care and Medical Leave An unpaid Family Care and Medical Leave shall be granted, to the extent of and subject to the restrictions as set forth below, to an employee who has been employed for at least twelve (12) months and who has served for one hundred thirty days (130) workdays during the twelve (12) months immediately preceding the effective date of the leave. For purposes of this section, furlough days and days worked during off-basis time shall count as "workdays". Family Care and Medical Leave absences of twenty (20) consecutive working days or less can be granted by the immediate administrator or designee. Leaves of twenty (20) or more consecutive working days can be granted only by submission of a formal leave application to the Classified Personnel Assignments Branch.

  • Medi Cal PII is information directly obtained in the course of performing an administrative function on behalf of Medi-Cal, such as determining Medi-Cal eligibility or conducting IHSS operations, that can be used alone, or in conjunction with any other information, to identify a specific individual. PII includes any information that can be used to search for or identify individuals, or can be used to access their files, such as name, social security number, date of birth, driver’s license number or identification number. PII may be electronic or paper. AGREEMENTS

  • Covered Health Care Services We agree to provide coverage for medically necessary covered health care services listed in this agreement. If a service or category of service is not specifically listed as covered, it is not covered under this agreement. Only services that we have reviewed and determined are eligible for coverage under this agreement are covered. All other services are not covered. See Section 1.4 for how we identify new services and our guidelines for reviewing and making coverage determinations. We only cover a service listed in this agreement if it is medically necessary. We review medical necessity in accordance with our medical policies and related guidelines. The term medically necessary is defined in Section 8.0 - Glossary. It does not include all medically appropriate services. The amount of coverage we provide for each health care service differs according to whether or not the service is received: • as an inpatient; • as an outpatient; • in your home; • in a doctor’s office; or • from a pharmacy. Also coverage differs depending on whether: • the health care provider is a network provider or non-network provider; • deductibles (if any), copayments, or maximum benefit apply; • you have reached your plan year maximum out-of-pocket expense; • there are any exclusions from coverage that apply; or • our allowance for a covered health care service is less than the amount of your copayment and deductible (if any). In this case, you will be responsible to pay up to our allowance when services are rendered by a network provider. Please see the Summary of Medical Benefits to determine the benefit limits and amount that you pay for the covered health care services listed below. Please see the Summary of Pharmacy Benefits to determine the benefit limits and amount that you pay for prescription drug and diabetic equipment and supplies purchased at a pharmacy.

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