Covered Charge definition

Covered Charge or “Expense” as used herein means those charges for any treatment, services, or supplies that are: a) for Network Providers, not in excess of the Preferred Allowance; b) for Non-Network Providers, not in excess of the Reasonable and Customary Expenses; c) not in excess of the charges that would have been made in the absence of this insurance except for institutions, controlled or owned by state and/or local governments, which provide services to indigent and non-indigent patients; and d) incurred while this Policy is in force as to the Insured Person except with respect to any expense payable under the Extension of Benefits Provision.

Covered Charge means those Medically Necessary services or supplies that are covered under this Plan.

Covered Charge means the amount billed by a dentist for a covered procedure during the term of the Contract.

Examples of Covered Charge in a sentence

• BCBSNM’s Covered Charge will be an amount up to but not in excess of the Covered Charge the Host Blue has passed on to BCBSNM.

• A Covered Charge is incurred on the date the service or supply is furnished.

• The Covered Charge will be an amount up to but not in excess of the allowable amount the Host Blue has passed on to BCBSNM.

• Purchase of a heavy duty/hospital grade breast pump is not considered Medically Necessary or a Covered Charge under this Plan.

• The copayment amount is not a Covered Charge under the medical Plan.

• BCBSNM will use the Host Blue’s Covered Charge as its Covered Charge so that your Claim can be processed timely.

• BCBSNM will use the Host Blue’s Covered Charge as its Covered Charge so that your claim can be processed timely.

• If a Covered Person:1) is eligible for early intervention services through the New Jersey Early Intervention System; and2) has been diagnosed with autism or other Developmental Disability; and3) receives physical therapy, occupational therapy, speech therapy, applied behavior analysis or related structured behavior services.Then the portion of the family cost share attributable to such services is a Covered Charge under this Plan.

• When there are postoperative complications following outpatient dental/oral surgery.No charge will be covered under Medical Benefits for dental and oral surgical procedures involving orthodontic care of the teeth, periodontal disease, and preparing the mouth for the fitting of or continued use of dentures, unless specifically stated as a Covered Charge under this Medical Benefit Descriptions section.

• A Covered Charge is considered incurred on the date the treatment or service is rendered or the supply is furnished.

More Definitions of Covered Charge

Covered Charge means the Reasonable and Customary Charge incurred for a service or supply which is performed or given under the direction of a Doctor for the Medically Necessary treatment of an Injury or Sickness. A Covered Charge is considered incurred on the date the treatment or service is rendered or the supply is furnished.

Covered Charge means the necessary and reasonable expenses incurred by an Insured for a Medically Necessary out-patient Prescription Drug that: 1) requires a written prescription by a Prescriber; 2) is dispensed in the Insured’s name by a licensed pharmacist;

Covered Charge or “Covered Expense” means only the expense incurred, or portion of such expense determined to be allowable after application of the appropriate discount, if any, for medical care, services or supplies that:

Covered Charge or “covered expense” means only the expense incurred, or portion of such expense determined to be allowable after application of the appropriate discount, if any, by the In- Network or Out-of-Area Network, for medical care, services or supplies that:

Covered Charge means a charge incurred by a person that is covered, in full or in part, by a health plan.

Covered Charge means those Medically Necessary treatments, services and supplies that are prescribed by an Approved Provider and actually incurred by the Participant during the Combined Benefit Period and subject to the Combined Benefit Amount Per Participant and Combined Benefit Amount Per Occurrence. A Covered Charge shall be deemed to have been incurred on the date the Medically Necessary treatment was rendered, a service given or a supply delivered. Pre-approved expenses for mileage, transportation, food and lodging will be included as Covered Charges. The determination of whether a treatment, service or supply is a Covered Charge will be made by the Claims Administrator.