Definitions for "Covered Services"
Related Terms:
Fee-for-service plan, Health benefit plan, Covered benefit, Non-participating provider, Preferred provider, Out-of-network, Prepaid health plan, Covered expense, Health plan, In-network, Preferred provider organization, Point-of-service plan, Ppo, Indemnity plan, Preferred provider network, Member, Indemnity health plan, Indemnity plans, Point of service, Exclusive provider organization, Participating provider, Preferred provider organizations, Fee for service, Provider network, Point-of-service, Health maintenance organizations, Point-of-service plans, Benefit package, Medicare hmo, Epo, Covered service, Medicare part b, Point of service plan, Nonparticipating provider, Fee-for-service, Closed panel, Managed care plan, Supplemental medical insurance, Dental health maintenance organization, Basic benefits, Original medicare, Preferred provider organization plan, Medicare managed care plan, Php , Original medicare plan, Carve-out, Medicare supplement plan, Part b, Network provider, Dhmo
are those medical and other services which Members are entitled to receive under their applicable plan document.
All medical, institutional and ancillary services and supplies to which a member is entitled to as described in their health care benefit plan.
Medical services considered eligible for coverage by your insurance plan
Services rendered to Medicare patients that are reimbursable by the program to the provider of service or supplier.
Health care services and products for which reimbursement is provided under the terms of the group health plan.
Services for which payment is provided under the terms of a policy.
Health services and benefits to which members are entitled under the terms of their benefit contract.
Those medically necessary health care services that are covered by a benefit agreement.
Hospital, medical, and other health care services and supplies provided to a Member for which Benefits are paid under a Contract.
Hospital, medical, and other health care services incurred by the enrollee that are entitled to a payment of benefits under a health benefit contract. The term defines the type and amount of expense, which will be considered in the calculation of benefits.
Those medical procedures the health plan agrees to pay for.
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."
Mandatory medical services required by HCFA and optional medical services approved by the State for which the enrolled provider will be reimbursed for services provided to eligible Medicaid recipients
Those medically necessary health care services, equipment and supplies which enrollee is entitled to receive under a plan's health benefits.
The services for which the “Plan” provides benefits under the terms of your contract.
Services for which a health care policy/contract will pay.
Services for which an insurance policy will pay.
the qualified long-term care services that are covered under a long-term care insurance policy
means services or supplies specified in this SPD, including any supplements, endorsements, addenda, or riders, for which benefits are provided, subject to the terms, conditions, limitations, and exclusions of this SPD.
Benefits, services, or supplies that are described in the Evidence of Coverage for which we are responsible and that have been previously approved through the Centers for Medicare and Medicaid Services (CMS).
The general term we use in this booklet to mean all of the health care services and supplies that are covered by Secure Health. Covered services are listed in the Benefits Chart in your Evidence of Coverage.
Those services and supplies as specified in this Certificate that meet Medically Necessary and reasonable guidelines and are provided by the Plan to its Members.
Services for which payment is provided under the terms of the dental benefit contract. Dental Plans
Services, supplies, equipment and care specifically listed in the covered services section of the contract, except those services, supplies, equipment and care excluded or subject to conditions and limitations identified in a contract.
The health care services your insurance company will pay for under your plan
The services and supplies covered by the health plan. The insurance company has an obligation to pay for these under the terms of the plan.
Those services, drugs or supplies identified as payable in the subscriber’s certificate that are determined to be medically necessary.
Specific services or supplies for which your insurance reimburses you or pays your health care provider. These consist of a combination of mandatory and optional services and vary by state.
the Healthcare Services provided to members under the terms of the Contract.
The qualified long term care services covered under the contract of insurance.
Medically necessary procedures, services, or supplies listed in the member’s benefits certificate.