charges for services rendered or supplies furnished by a dentist that qualify as covered services and are paid for in whole or in part by the dental benefit program. May be subject to deductibles, copayments, coinsurance, annual or lifetime maximums, as specified by the terms of the contract.
Charges for medical care or supplies that, if incurred by an insured or other covered person, create a liability for the insurer or plan under terms of a policy.
Any hospital, medical, and miscellaneous health care expenses incurred by the insured that are payable either partially or fully under his/her health insurance policy. Also called "covered expenses," "covered benefits," or "covered charges."
A health service or benefit that is paid partially or fully by a person's health plan.
Services or benefits for which the health plan makes either partial or full payment.
Those health care expenses covered by the health plan. These charges may be subject to a co-payment or a deductible.
What the plan pays for. Youll find information about covered benefits, expenses and services in each plans brochure.
Those charges which are considered medically necessary and which are within the terms and conditions of your benefit plan. To be covered, all medical and surgical services, supplies and treatment must be considered medically necessary and provided on the recommendation and approval of a qualified provider.