Medicare Benefits definition

Medicare Benefits means those benefits actually provided under Part A (hospital benefits) or Part B (medical benefits) of Medicare to an individual having entitlement thereto, who made claim there- fore, or the equivalent of those benefits. Medicare Eligible Expenses means expenses of the kinds covered by Medicare Part A and B to the extent recognized as reasonable and medically necessary by Medicare. Outpatient means a Subscriber receiving Ser- vices under the direction of a Physician, but not as an Inpatient. Physician means any practitioner as defined un- der Medicare. Services means medically necessary health care services and medically necessary supplies fur- nished incident to those services. Sickness means an illness or disease of a covered person which first manifests itself after the effec- tive date of the Agreement and while coverage is in effect. Skilled Nursing Facility means a facility which participates in the Medicare program and is li- censed by the California Department of Health Services as a "Skilled Nursing Facility," or a simi- lar institution licensed by another state, a United States Territory, or a foreign country. Subacute Care means skilled nursing or skilled rehabilitative care provided in a hospital or skilled nursing facility to patients who require skilled care such as nursing services, physical, occupa- tional, or speech therapy; a coordinated program of multiple therapies or who have medical needs that require daily Registered Nurse monitoring. A facility which is primarily a rest home, convales- cent facility, or home for the aged is not included. Subscriber means a person whose status is the basis for eligibility for membership in this Medi- care Supplement Plan, who is enrolled by Blue Shield, and maintains coverage in accordance with this Agreement. Total Disability (or Totally Disabled) means the incapability of self-sustaining employment by reason of mental retardation or physical handicap. United States means all of the States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and American Samoa.
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Medicare Benefits means those benefits actually provided under Part A (hospital benefits) or Part B (medical benefits) of Medicare to an individual having entitlement thereto, who made claim therefore, or the equivalent of those benefits. Medicare Eligible Expenses means expenses of the kinds covered by Medicare Part A and B to the extent recognized as reasonable and medically necessary by Medicare. Outpatient means a Subscriber receiving Services under the direction of a Physician, but not as an Inpatient. Physician means any practitioner as defined under Medicare. Services means medically necessary health care services and medically necessary supplies furnished incident to those services. Sickness means an illness or disease of a covered person which first manifests itself after the effective date of the Agreement and while coverage is in effect. Skilled Nursing Facility means a facility which participates in the Medicare program and is licensed by the California Department of Health Services as a "Skilled Nursing Facility," or a similar institution licensed by another state, a United States Territory, or a foreign country. Subacute Care means skilled nursing or skilled rehabilitative care provided in a hospital or skilled nursing facility to patients who require skilled care such as nursing services, physical, occupational, or speech therapy; a coordinated program of multiple therapies or who have medical needs that require daily Registered Nurse monitoring. A facility which is primarily a rest home, convalescent facility, or home for the aged is not included. Subscriber means a person whose status is the basis for eligibility for membership in this Medicare Supplement Plan, who is enrolled by Blue Shield, and maintains coverage in accordance with this Agreement. Total Disability (or Totally Disabled) means the incapability of self-sustaining employment by reason of mental retardation or physical handicap. United States means all of the States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and American Samoa.
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Medicare Benefits means those benefits actually provided under Part A (hospital benefits) or Part B (medical benefits) of Medicare to an individual having entitlement thereto, who made claim there- fore, or the equivalent of those benefits.
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Examples of Medicare Benefits in a sentence

  • Benefits for Foot OrthoticsMedically Necessary foot orthotics that are consistent with the Medicare Benefits Policy Manual are covered subject to the same Deductibles, Coinsurance Amounts and Copayment Amounts as for services and supplies generally.

  • This Plan will coordinate benefits with Medicare whether or not the Covered Person is actually receiving Medicare Benefits.

  • In addition, if during the continuation period the former Employee becomes entitled to Medicare Benefits and such event would not have resulted in coverage termination, such second event shall not be considered a second qualifying event.

  • Limitations: If an individual is enrolled in Medicare, Benefits for Covered Services will be coordinated with any benefits paid by Medicare.

  • You will receive an Explanation of Medicare Benefits (EOMB) after Medicare Part B processes the Claim indicating Medicare’s payment, amount applied to the Deductible, and your responsibility.

  • This contribution will begin upon retirement and continue until the retiree is eligible to receive Medicare Benefits.

  • In the event it is not filed electronically, We must receive the Explanation of Medicare Benefits Form.

  • The explanation of Medicare Benefits (EOMB) reflects a message that the claim was referred to SoonerCare.

  • Rationale for Question: To better understand the value proposition and strategic business model of the independent broker company in Manitoba and their economic dependence on MPI and the purse of the policyholders.

  • A medical practitioner shall assess the fee to be charged on a referred insured patient and shall inform the patient if the fee to be charged is to exceed the Commonwealth Medicare Benefits Schedule fee and shall on request, provide the hospital with a certificate that the above procedure has been followed.


More Definitions of Medicare Benefits

Medicare Benefits means those benefits actually provided under Part A (hospital benefits) or Part B (medical benefits) of Medicare to an individual having entitlement thereto, who made claim there- fore, or the equivalent of those benefits. Medicare Eligible Expenses means expenses of the kinds covered by Medicare Part A and B to the extent recognized as reasonable and medically nec- xxxxxx by Medicare. Outpatient means a Subscriber receiving Services under the direction of a Physician, but not as an In- patient. Physician means any practitioner as defined under Medicare. Services means medically necessary health care services and medically necessary supplies fur- nished incident to those services. Sickness means an illness or disease of a covered person which first manifests itself after the effec- tive date of the Agreement and while coverage is in effect. Skilled Nursing Facility means a facility which participates in the Medicare program and is li- censed by the California Department of Health Ser- vices as a "Skilled Nursing Facility," or a similar institution licensed by another state, a United States Territory, or a foreign country. Subacute Care means skilled nursing or skilled re- habilitative care provided in a hospital or skilled nursing facility to patients who require skilled care such as nursing services, physical, occupational, or speech therapy; a coordinated program of multiple therapies or who have medical needs that require daily Registered Nurse monitoring. A facility which is primarily a rest home, convalescent facil- ity, or home for the aged is not included.
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Medicare Benefits means benefits for services and supplies which the Eligible Person receives or is entitled to receive under Medicare Part A or B.
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Medicare Benefits means those benefits actually provided under Part A (hospital benefits) or Part B (medical benefits) of Medicare to an in- dividual having entitlement thereto, who made claim therefore, or the equivalent of those bene- fits. MEDICARE ELIGIBLE EXPENSES means expenses of the kinds covered by Medicare Part A and B to the extent recognized as reasonable and medically necessary by Medicare. OUTPATIENT means a Subscriber receiving Services under the direction of a Physician, but not as an Inpatient. PHYSICIAN means any practitioner as defined under Medicare. SERVICES means medically necessary health care services and medically necessary supplies furnished incident to those services. SICKNESS means an illness or disease of a cov- ered person which first manifests itself after the effective date of the Agreement and while cover- age is in effect. SKILLED NURSING FACILITY means a fa- cility which participates in the Medicare program and is licensed by the California Department of Health Services as a "Skilled Nursing Facility", or a similar institution licensed by another state, a United States Territory, or a foreign country. SUBACUTE CARE means skilled nursing or skilled rehabilitative care provided in a hospital or skilled nursing facility to patients who require skilled care such as nursing services, physical, oc- cupational, or speech therapy; a coordinated pro- gram of multiple therapies or who have medical needs that require daily Registered Nurse moni- toring. A facility which is primarily a rest home, convalescent facility or home for the aged is not included.
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Medicare Benefits means those benefits actually provided under Part A (hospital benefits) or Part B (medical benefits) of Medicare to an individual having entitlement thereto, who made claim there- fore, or the equivalent of those benefits. Medicare Eligible Expenses means expenses of the kinds covered by Medicare Part A and B to the extent recognized as reasonable and medically nec- xxxxxx by Medicare. VSP Non-Participating Provider means a li- censed ophthalmologist, optometrist, or dispensing optician who has not certified and not accepted the terms of the Agreement. VSP Participating Provider means a licensed ophthalmologist, optometrist, or optician who has certified his willingness to accept the terms and conditions and compensations as payment in full for covered services as set forth in the VSP con- tract. Outpatient means a Subscriber receiving Services under the direction of a Physician, but not as an In- patient. Physician means any practitioner as defined under Medicare. Services means medically necessary health care services and medically necessary supplies fur- nished incident to those services. Sickness means an illness or disease of a covered person which first manifests itself after the effec- tive date of the Agreement and while coverage is in effect. Skilled Nursing Facility means a facility which participates in the Medicare program and is li- censed by the California Department of Health Ser- vices as a "Skilled Nursing Facility," or a similar institution licensed by another state, a United States Territory, or a foreign country. Subacute Care means skilled nursing or skilled re- habilitative care provided in a hospital or skilled nursing facility to patients who require skilled care such as nursing services, physical, occupational, or speech therapy; a coordinated program of multiple therapies or who have medical needs that require daily Registered Nurse monitoring. A facility which is primarily a rest home, convalescent facil- ity, or home for the aged is not included. Subscriber means a person whose status is the ba- sis for eligibility for membership in this Medicare Supplement Plan, who is enrolled by Blue Shield, and maintains coverage in accordance with this Agreement. Total Disability (or Totally Disabled) means the incapability of self-sustaining employment by rea- son of mental retardation or physical handicap. United States means all of the States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, and Americ...
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Medicare Benefits has the same meaning as it has in the Health Insurance Act 1973 of the Parliament of the Commonwealth.
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Medicare Benefits means those benefits under Title XVIII of the Social Security Act, as amended from time to time.
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Related to Medicare Benefits

  • Medicare benefit means the Medicare benefit payable within the meaning of Part II of the Health Insurance Act 1973 with respect to a professional service.

  • Welfare Benefits means the types of benefits described in Section 3(1) of ERISA (whether or not covered by ERISA).

  • Health and Welfare Benefits means any form of insurance or similar benefit programs, which may include but not be limited to, medical, hospitalization, surgical, prescription drug, dental, optical, psychiatric, life, or long-term disability.

  • Retiree means any person who has begun accruing a retirement

  • Medicare means the “Health Insurance for the Aged Act,” Title XVIII of the Social Security Amendments of 1965, as then constituted or later amended.

  • Health Benefits means health maintenance organization, insured or self-funded medical, dental, vision, prescription drug and behavioral health benefits.

  • Medical Benefits means medical, optical, or dental benefits, including, but not limited to, hospital and physician services, prescription drugs, and related benefits.

  • Health care worker means a person other than a health care professional who provides medical, dental, or other health-related care or treatment under the direction of a health care professional with the authority to direct that individual's activities, including medical technicians, medical assistants, dental assistants, orderlies, aides, and individuals acting in similar capacities.

  • Fringe benefits means the amount of:

  • Dental means of or relating to the teeth and the work of a dentist.

  • Gap medical benefits means the benefits (if any) payable in respect of medical expenses that are less than, greater than or equal to the schedule fee, provided always that the medical expenses relate to a professional service that:

  • Health care coverage means any plan providing hospital, medical or surgical care coverage for

  • Medicare Advantage plan means a plan of coverage for health benefits under Medicare Part C as defined in 42 U.S.C. 1395w-28(b)(1), and includes:

  • Medicare Advantage The Medicare managed care options that are authorized under Title XVIII as specified at Part C and 42 C.F.R. § 422.

  • Health means physical or mental health; and

  • Medicare Provider Agreement means an agreement entered into between CMS (or other such entity administering the Medicare program on behalf of the CMS) and a health care provider or supplier, under which such health care provider or supplier agrees to provide services for Medicare patients in accordance with the terms of the agreement and Medicare Regulations.

  • Retiree Health Plan means an "employee welfare benefit plan" within the meaning of Section 3(1) of ERISA that provides benefits to individuals after termination of their employment, other than as required by Section 601 of ERISA.

  • Medical Benefits Schedule means the Medicare Schedule of Benefits produced by the Department of Health to which all fees and benefits relate for inpatient hospital services.

  • Health care plan means any contract, policy or other arrangement for benefits or services for medical or dental care or treatment under:

  • Unemployment Insurance means the contribution required of Vendor, as an employer, in respect of, and measured by, the wages of its employees (or subcontractors) as required by any applicable federal, state or local unemployment insurance law or regulation.

  • Health Plans means any and all individual and family health and hospitalization insurance and/or self-insurance plans, medical reimbursement plans, prescription drug plans, dental plans and other health and/or wellness plans.

  • superannuation benefits means pensions, gratuities and other allowances payable on resignation, retirement or death;

  • Medicaid means the medical assistance programs administered by state agencies and approved by CMS pursuant to the terms of Title XIX of the Social Security Act, codified at 42 U.S.C. 1396 et seq.

  • Health benefits plan means a benefits plan which pays or

  • Credit unemployment insurance means insurance:

  • Compensation and Benefits Programs means all compensation and benefit plans, policies, and programs of the Debtors, and all amendments and modifications thereto, applicable to the Debtors’ employees, former employees, retirees, and non-employee directors and the employees, former employees and retirees of their subsidiaries, including all savings plans, retirement plans, health care plans, disability plans, and incentive plans, deferred compensation plans, and life, accidental death, and dismemberment insurance plans.