Out of Pocket means the difference between the fund benefit for a treatment or service and the provider’s fees and is payable by the member.
Out of Pocket means the maximum dollar amount per year of eligible charges payable by an Insured to Providers. Co-payment amounts and Prescription Drug costs do not apply to the Out-of-Pocket maximum amount and no individual family member may contribute more than one-half of the Family Out-of-Pocket maximum. Only eligible Deductible and co-insurance amounts (except co-insurance amounts paid towards Prescription Drugs or for any Benefits which are not eligible to be paid at 100%) that are paid by the Insured during the Calendar Year will be applied toward the satisfaction of the Out-of-Pocket maximum. Deductible amounts must be satisfied for each individual family member (unless the Family Deductible has been satisfied) even if the Family Out- of-Pocket maximum amount has been satisfied. The Out-of-Pocket amounts are specified in the Schedule of Benefits section of this booklet.
Out of Pocket maximum means:
Examples of Out of Pocket in a sentence
All amounts paid as Copayment, Deductible and Coinsurance shall count toward the [Tier 1] Network Maximum Out of Pocket.
All amounts paid as Copayment, Deductible and Coinsurance shall count toward the [Tier 2] Network Maximum Out of Pocket.
All amounts paid as Copayment, Deductible and Coinsurance shall count toward the Maximum Out of Pocket.
Once the [Tier 1] Network Maximum Out of Pocket has been reached, the Member has no further obligation to pay any amounts as Copayment, Deductible and Coinsurance for [Tier 1] Network Covered Services and Supplies for the remainder of the Calendar Year.
Once the [Tier 1] Network Maximum Out of Pocket has been reached, the Member has no further obligation to pay any amounts as Copayment, Deductible and Coinsurance for [Tier 1] Network Covered Services and Supplies for the remainder of the [Calendar] [Plan] Year.
More Definitions of Out of Pocket
Out of Pocket expenses shall mean all those monies reasonably paid by or for and on behalf of the Contractor to any third party and in particular includes the hire of men, tugs, other craft and equipment used and other expenses reasonably necessary for the operation. They will be agreed at cost, PROVIDED THAT:
Out of Pocket or “Out-of-Pocket Maximum” shall mean a dollar amount paid by the Participant which includes Deductible, Coinsurance, and Copayment amounts. It does not include penalties for failure to obtain Pre- Certification, premiums, amounts in excess of the Allowable Charge, charges for non-Covered Services, and charges after Covered Services have been exhausted, and ancillary fees for a brand-name drug product when a generic equivalent prescription Drug is available for substitution.
Out of Pocket means, with respect to a payment, that a Party or one of its Subsidiaries (as applicable) actually pays the relevant amount of such payment, and neither such Party nor any Subsidiary of such Party has obtained, or is permitted to obtain and obtains, an offset, credit or reimbursement for, any such amount from a Third Party.
Out of Pocket means copayments, deductibles or fees paid by members for health services or prescriptions.
Out of Pocket. EXPENSES shall mean all of the Agent's (and the Lenders upon the occurrence of an Event of Default which is not waived by the Required Lenders) present and future expenses incurred relative to this Financing Agreement or any other Loan Documents, whether incurred heretofore or hereafter, which expenses shall include, without being limited to: the cost of record searches, all costs and expenses incurred by the Agent in opening bank accounts, depositing checks, receiving and transferring funds, and wire transfer charges, any charges imposed on the Agent due to returned items and "insufficient funds" of deposited checks and the Agent's standard fees relating thereto, any amounts paid by, incurred by or charged to, the Agent and/or the Lenders by the Issuing Bank under a Letter of Credit Guaranty or a Company's reimbursement agreement, application for Letters of Credit or other like document which pertain either directly or indirectly to such Letters of Credit, and the Agent's standard fees relating to the Letters of Credit and any drafts thereunder, travel, lodging and similar expenses of the Agent's personnel in connection with inspecting and monitoring the Collateral from time to time hereunder, any applicable counsel fees and disbursements, fees and taxes relative to the filing of financing statements, all expenses, costs and fees set forth in Paragraph 10.3 of Section 10 of this Financing Agreement, all fees and disbursements (including, without limitation, all reasonable fees and disbursements of in-house and outside counsel to Agent) incurred as a result of a workout, restructuring, reorganization, liquidation, insolvency proceeding and in any appeals arising therefrom whether incurred before, during or after the termination of this Financing Agreement or the commencement of any case with respect to any of the Companies or Guarantors under the United States Bankruptcy Code or any similar statute; and title insurance premiums, real estate survey costs, note taxes, intangible taxes and mortgage or recording taxes and fees ."
Out of Pocket means those expenses requiring an outlay of funds.
Out of Pocket expenses shall mean all t h ose m o nies r easo nably paid by or for an d o n behalf of t he Con tractor to any t hir d party an d in particular includes t he hir e of men, tugs, ot her craft an d