Benefits and Coverage means the dental health care services available under the Geographic Managed Care Program and dental provisions of the California Medi-Cal program.
Benefits and Coverage means the health and health-related services we provide you through this plan. These services take the place of the benefits you would otherwise receive through Medicaid and Medicare.
Benefits and Coverage means the dental care services available under the Group Subscriber Benefit Agreement in which a member is enrolled.
Examples of Benefits and Coverage in a sentence
When you look at the Summary of Benefits and Coverage for other plans, you’ll find the same Coverage Examples.
Refer to your Summary of Benefits and Coverage for your Cost Sharing amount.
Refer to your Summary of Benefits and Coverage for your visit limitations.
Refer to the rehabilitation and habilitation section of your Summary of Benefits and Coverage for your Cost Sharing amount.
You should keep this Agreement, your Summary of Benefits and Coverage, and any other attachments or Endorsements you may receive for future reference.
More Definitions of Benefits and Coverage
Benefits and Coverage. OR “COVERED DENTAL SERVICES” means the health care services available as listed as covered services in Section V and the Summary Benefit Schedule which are necessary for the dental health of the enrollee according to professionally recognized standards of practice.
Benefits and Coverage means the health and health-related services we provide you through this plan. These services take the place of the benefits you would otherwise receive through Medicaid and Medicare. This is made possible through a special arrangement between Trinity Health LIFE New Jersey, and Medicaid (New Jersey Department of Health and Senior Services) and the Centers for Medicare and Medicaid Services (CMS). This Contract gives you the same benefits you would receive under Medicaid and Medicare plus many additional benefits. To receive any benefits under this plan, you must meet the conditions described in this handbook.
Benefits and Coverage means the health and health-related services we provide you through this plan. These services take the place of the benefits you would otherwise receive through Medicaid and Medicare. This is made possible through a special arrangement between Mercy LIFE, Medicaid (Executive Office of Health and Human Services), and the Centers for Medicare and Medicaid Services (CMS). This contract gives you the same benefits you would receive under Medicaid and Medicare plus many additional benefits. To receive any benefits under this plan, you must meet the conditions described in this Enrollment Agreement.
Benefits and Coverage is modified to read as follows: “This section explains what medical services Xxxxxx Healthcare covers for the Member, also known as Member’s Benefits and Coverage or Covered Services. For a service to be covered, it must be Medically Necessary. You have the right to appeal if a service is denied. Turn to page 83 for information on how You can have Your case reviewed. See the “Grievances (Internal Appeals) and External Appeals” section.. Your care must not be Experimental or Investigational. However, You may ask to be part of Experimental or Investigational care. Go to page 23 for prior authorization information. Xxxxxx Healthcare also may cover routine medical costs for Members in approved clinical trials. Go to page 52 to find out more.”
Benefits and Coverage means the health and health-related services TRU PACE provides you. These services take the place of the benefits you would otherwise receive through Medicaid and Medicare. This is made possible through an agreement between TRU Community Care, and HCPF and CMS. This agreement gives you the same benefits you would receive under Medicaid and Medicare plus many additional benefits. To receive any benefits from TRU PACE, you must meet the conditions described in this Enrollment Agreement. "Eligible for Nursing Facility Level of Care" means that your health status, as evaluated by either Boulder or Weld County Single Entry Point Team, meets the Colorado criteria for placement in a nursing facility and/or skilled nursing facility care. Although you must meet the nursing facility level of care to be accepted as a participant in TRU PACE, you may receive those services in the home instead of in a nursing facility. TRU PACE's goal is to maintain your independence in the community as long as it is medically and socially feasible.
Benefits and Coverage means the dental health care services available under the Los Angeles County Prepaid Health Plan Program and dental provisions of the California Medi-Cal program defined in Title 22, Sections 51059, 51307, and 53910.5.2.
Benefits and Coverage means the health care services available under a plan contract.