Calendar Year Deductible definition

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable Calendar Year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each Calendar Year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Covered Employee and Covered Dependents.
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Calendar Year Deductible means the first dollar amount of your Part A and/or Part B charges incurred outside of the United States during a Calendar Year.
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Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Contractholder and Covered Dependents. Third-party Copayment assistance (sometimes also referred to as a “copay card” or “copay coupon”) provided by a drug manufacturer toward your cost-sharing for Covered Services including Specialty Medications, does not apply toward satisfaction of the Deductible.
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Examples of Calendar Year Deductible in a sentence

  • When you receive Covered Services from a Participating Provider, you are only responsible for the Copayment or Coinsurance, once any Calendar Year Deductible has been met.Teladoc.

  • When you receive Covered Services from a Participating Provider, you are only responsible for the Copayment or Coinsurance, once any Calendar Year Deductible has been met.

  • Up to the number of days or visits shown for each category of Extended Care Expense on your Schedule of Coverage.If shown on your Schedule of Coverage, the Calendar Year Deductible will apply.

  • When you receive Covered Services from a Non-Participating Provider, you are responsible for:• the Copayment or Coinsurance (once any Calendar Year Deductible has been met), and• any charges above the Allowable Amount.

  • If shown on your Schedule of Coverage, the Calendar Year Deductible will apply.

  • When you receive Covered Services from a Participating Provider, you are only responsible for the Copayment or Coinsurance, once any Calendar Year Deductible has been met.Your payment for services from “Other Providers.” You will pay the Copayment or Coinsurance applicable to Participating Providers for Covered Services received from Other Providers.

  • Out-of-Network Provider means a Hospital, Physician, Behavioral Health Practitioner, or Other Provider who has not entered into an agreement with BCBSTX (or other participating Blue Cross and/or Blue Shield Plan) as a managed care Provider.Out-of-Pocket Maximum means the cumulative dollar amount of Eligible Expenses, including the Calendar Year Deductible, incurred by a Participant during a Calendar Year.

  • When you receive Covered Services from a Non-Participating Provider, you are responsible for:• the Copayment or Coinsurance (once any Calendar Year Deductible has been met), and• any charges above the Allowable Amount, or• any charges above the stated dollar amount, which is the Benefit maximum.

  • Certain Covered Services may not be subject to the Calendar Year Deductible, as shown in your Schedule of Benefits.

  • Any amounts you pay that count towards the medical Calendar Year Deductible also count towards the Calendar Year Out-of-Pocket Maximum.This Plan has a separate Participating Provider OOPM and Non-Participating Provider OOPM.Family coverage has an individual OOPM within the Family OOPM.


More Definitions of Calendar Year Deductible

Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount a Member owes for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Contractholder and Covered Dependents. Third-party assistance toward Member’s share of the cost for Covered Services, including Specialty Medications, does not apply toward satisfaction of the Deductible.
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Calendar Year Deductible means the first payments up to a specified dollar amount that a Member must make in the applicable calendar year for Covered Benefits. It is the amount you owe for certain Covered Services before AvMed begins to pay, and must be satisfied once each calendar year. The Calendar Year Deductible may not apply to all services. The Deductible applies to each Member, subject to any family Deductible listed on the Schedule of Benefits. For purposes of the Deductible, “family” means the Covered Employee and Covered Dependents. Third-party Copayment assistance by a drug manufacturer or any other entity toward your cost-sharing for Covered Services including Specialty Medications, does not apply toward satisfaction of the Deductible.
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Calendar Year Deductible means the out-of-pocket amount to be borne each Calendar Year by the Covered Person before dental expenses will be paid by the Plan. Such Deductible will be paid to the Dental Care Provider with respect to initial charges for services in each Calendar Year, and is separate from (in addition to) the Deductible for medical Benefits.
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Related to Calendar Year Deductible

  • Calendar Year means each successive period of twelve (12) calendar months commencing on January 1 and ending on December 31.

  • Crop year means any 12 month period which represents the planting, growing, harvesting and marketing of an insurable crop, as stated in the Schedules;

  • Limitation Year means the Plan Year.

  • Annual Net Sales means, with respect to any Calendar Year, the aggregate amount of the Net Sales for such Calendar Year.

  • Base Year Value means the assessed value of eligible property January 1 preceding the execution of the agreement plus the agreed upon value of eligible property improvements made after January 1 but before the execution of the agreement.

  • Election Year means a year in which ordinary elections for local governments are required to be held;

  • Eligible Expense means the lesser of the reasonable, customary, usual, fair market value charge for a covered service or the provider's actual charge.

  • Floating Profit/Loss means current profit/loss on Open Positions calculated at the current Quotes.

  • Three-Year Period means, with respect to a Restatement, the three completed fiscal years immediately preceding the date that the Board, a committee of the Board, or the officer or officers of the Company authorized to take such action if Board action is not required, concludes, or reasonably should have concluded, that the Company is required to prepare such Restatement, or, if earlier, the date on which a court, regulator or other legally authorized body directs the Company to prepare such Restatement. The “Three-Year Period” also includes any transition period (that results from a change in the Company’s fiscal year) within or immediately following the three completed fiscal years identified in the preceding sentence. However, a transition period between the last day of the Company’s previous fiscal year end and the first day of its new fiscal year that comprises a period of nine to 12 months shall be deemed a completed fiscal year.

  • Maximum Benefit Amount means the maximum amount payable for coverage provided to You as shown in the Schedule of Benefits.