Affordable and quality health insurance for employer groups NEWSLETTER FEBRUARY
|
|
|
- Ellen Boone
- 5 years ago
- Views:
Transcription
1 Affordable and quality health insurance for employer groups NEWSLETTER FEBRUARY
2 Topics for discussion: 1. Gym & Wellness Benefits Fund Calendar 2. Add On Benefits Product Structure 3. Over Aged Dependents Discontinuation of Gym and selected wellness benefits Dear Members As per Namfisa directive (PI/MAF/DIR/01/2017) dated 15th December 2017, no Medical Aid Fund may pay for gym rebates and selected wellness benefits as from the 15th of December 2017, as these services do not constitute medical services. In terms of the Medical Aid Fund Act No.23 of 1995, the purpose of a medical aid fund is to provide financial or other assistance to members of the fund and their dependants in defraying expenditure incurred by them in connection with the rendering of any medical service Medical Service means any health care treatment of any person, by a person registered in terms of any law, which treatment has as its object as the diagnosis, treatment or prevention of any physical or mental defect, illness or deficiency; The giving of advice in relation to any such defect, illness or deficiency; In order to comply with the directive, the Board of Trustees would like to notify all members that the Gym and I Quit Smoking benefits were discontinued under the Napotel Benefit Offering effective 15 December The 2018 amended Benefit Structure is attached on page Add-On Benefits Members are hereby notified that all Add-on benefits taken out in 2017 were terminated on 31 December No Add-On Benefits was carried over to the 2018 financial year. Members who wish to continue with their add-on benefits for 2018 should re-apply by submitting new application forms to the Napotel Office. Documentation to be submitted as proof: Students from years proof of full time studies for Dependants with Mental or Physical disability: Doctor s letter confirming the disability NB: Members should submit proof as highlighted under 4.1 before 31 March Members are cautioned that if no proof is submitted, membership of dependents older than 21 years will be terminated on the Fund effective 1 April Fund Annual Calendar 4.1. Ex-Gratia Meeting dates: 21 February 25 April 28 June 29 August 30 October 04 December 4.2 Board of Trustees Meetings 08 March 17 May 26 July 27 July 22 November 4.3 Annual General Meeting (AGM) 11 June Over Aged dependents In terms of the rules of the Napotel Medical Aid Fund, a member s child over the age of 21 years but not over the age of 25 years is entitled to remain as a dependant of a member of the Fund under the following conditions; A full time student at a registered institution until such a student reaches the maximum age of 25. Dependant of the member owing to mental or physical defects or similar cause.
3 PRODUCT STRUCTURE 2018: IN-HOSPITAL BENEFITS B1 AMENDED BENEFIT STRUCTURE Hospital Benefits Group (Subject to clinical risk management protocols and preauthorisation) Private Hospitals including medicines, materials, hospital apparatus and 7 days take out medication Provincial Hospitals including medicines, materials, hospital apparatus and 7 days take out medication Step-down Nursing Facilities in lieu of hospitalization GP Consultation, treatment & services Overall Annual Limit of per family per annum Part of the Overall Annual limit Specialist consultations, treatment and services Blood Transfusion Pathology/Radiology per beneficiary B2 Internal Medical Prosthesis per beneficiary Internal Prosthesis - example: Knee/Hip/Pacemakers. Including intra ocular lenses. Subject to pre-authorization and clinical risk management protocols. 100% cost Part of the Sub-limit B2 B3 MRI/CT Scans (In/Out Hsp) per beneficiary In and Out of Hospital Benefit. Subject to preapproval and Clinical protocols. Part of the Sub-limit B3 B4 Psychiatric Accommodation treatment and services 21 days Including Psychiatric hospital Accommodation, Subject to 21 days per treatment and services. Subject to clinical beneficiary per annum protocols and pre-authorization B5 Alcohol and Drug Rehabilitation per beneficiary Alcohol & Drug Addiction, addiction Therapy, related Pathology and medication. (Part of Part of the Sub-limit of B5 treatment plan protocols) Annual benefit. Alcohol & Drug medication Levy 15% minimum N$30 maximum N$60 B6 Refractive Surgery per beneficiary including Excimer Laser and Radial Keratotomy Part of the Sub-limit B6
4 PRODUCT STRUCTURE 2018: IN-HOSPITAL BENEFITS B7 Maternity PART OF OAL Hospital Caesarean (Non-Emergency) Part of the Overall Annual limit GP and specialist Caesarean(Non-Emergency) (Hsp) 10% co-payment Hospital Confinement/Caesarean (Emergency) GP and Specialist Part of the Overall Annual limit Confinement/Caesarean(Emergency)(Hospital) GP/Specialists Confinement(In Rooms) 12 visits Maternity scans 3 scans B8 Circumcision PART OF OAL Hospital circumcision subject to authorization Part of the Overall Annual limit GP and specialists circumcision(in Hospital) 10% co-payment GP and specialist circumcision done in Rooms Part of the Overall Annual limit B9 Gastroscopy & Colonoscopy PART OF OAL Hospital Gastroscopy/Colonoscopy 5% co-payment GP and specialist Gastroscopy/Colonoscopy(Hospital) 5% co-payment B10 Renal (Kidney) Dialysis PART OF OAL Hospital Admission Renal/Kidney Dialysis GP and Specialists Kidney Dialysis (Hospital GP and Specialists Kidney Dialysis (Rooms) part of the OAL Kidney/Organ Medication B11 Organ Transplant PART OF OAL GP and Specialists - Organ Transplants (Hospital) GP and Specialists - Organ Transplants Part of Overall annual limit (Rooms) Organ medication B12 Oncology Treatment per beneficiary GP and Specialists - Oncology(Hospital) GP and Specialists - Oncology(Rooms) Chemo Medication Part of Overall sublimit B12 B13 MVA/Third Party per event MVA/Third Party(Hospital) GP and specialist treatment and services MVA/Third Party(Rooms) MVA Medication Part of the event limit B13
5 PRODUCT STRUCTURE 2018: IN-HOSPITAL BENEFITS B14 Maxillo Facial per beneficiary Non-Elective Maxillo Facial/Oral Surgery - Trauma. Including Dental extractions of more than 3 teeth or multiple fillings in children under the age of ten and disabled dependants/ Removal of impacted wisdom Part of the sub-limit B14 teeth. (All Inclusive Benefit - surgery, treatment and services). Part of Clinical protocols B15 Auxiliary Services PART OF OAL Including Physiotherapy, Biokenetics, Occupational therapy in Hospital Part of the Overall Annual limit B16 Alternatives to Hospitalization Frail Care, Private Nursing (home nursing and Hospice B17 Ambulance Services Inter-hospital ambulance transfers Travel assistance to South Africa Travel assistance to Namibia on specialist referrals Accommodation (specialist referral Namibia per family 100% Part of the Sub-limit B16 STIPULATED LIMITS per beneficiary per beneficiary 100% of cost per beneficiary N$420 per day Accommodation (specialist referral South Africa B18 HIV/AIDS BENEFIT N$540 per day PER BENEFICIARY Hospital treatment and services per beneficiary per annum sublimit to B18 HIV/Aid medication per beneficiary per annum sublimit to B18 Counseling per beneficiary per annum sublimit to B18 Consultations 12 visits per beneficiary per annum sublimit to B18 Radiology and Pathology per beneficiary sublimit to B18
6 PRODUCT STRUCTURE 2018: DAY TO DAY BENEFITS C1 Professional Services (M) (M1) (M2) (M3) (M4) (M5+) GP/Specialist and Primary Health Consultations including Out patient Visits. Part of the Sub-limit C1 GP and specialists and Primary Health care Procedures in Rms Radiology and Pathology Part of the Sub-limit C1 C2 Acute Medication (M) (M1) (M2) (M3) (M4) (M5+) Acute medication including Primary Healthcare Scripts 15% levy minimum N$30 maximum N$65 GP/Specialist and Primary Health Care Injections and materials Homeopathic medication C3 Chronic Medication per beneficiary Chronic medication (preferred) no levy Chronic medication (non- preferred) 15% levy minimum N$30 maximum N$65 C4 OTC medication (M) 810 (M1) (M2) (M3) (M4) (M5+) OTC medication part of sublimit C4 C5 External Appliances per beneficiary General appliances including artificial limbs, eyes, wheelchairs, hearing aids and all approved appliances 100% cost Part of the Sub-limit C5 C6 Auxiliary Services per beneficiary Including Physiotherapy, Social Workers, Speech, Audiology, Acousticians, Dieticians, Occupational Therapy, Biokenetics, Homeopath/ Chiro/ Osteopathy, Podiatry, Acupuncture etc. Part of the Sub-limit C6 C7 Psychology & Psychiatry per beneficiary Clinical Psychology Part of the Sub-limit C7 Psychiatric treatment
7 PRODUCT STRUCTURE 2018: DAY TO DAY BENEFITS C8 Dentistry (M) (M1) (M2) (M3) (M4) (M5+) Including Conservative dentistry, specialized dentistry and selected maxilllo facial procedures in rooms (orthodontic treatment) Part of the Sub-limit C8 C9 Optical Services per beneficiary every 2 years Frames 100% cost per beneficiary part of sublimit C9 Eye Test 2 eye tests per beneficiary Lenses/Contact Lenses Part of the Sub-limit C9 Bi-Focal Lenses in addition to the Optical benefit limit - where a bi-focal lenses is prescribes members will have an additional amount of N$ % N$2 000 per beneficiary COMPLIMENTARY BENEFITS Preventative Part of the OAL Baby Immunizations 0-6 years Cholesterol/Test Blood Sugar(Finger Prick) 1 per beneficiary Mammogram 1 per female beneficiary (>40 years) DEXA Bone Density scan) 1 per beneficiary (> 50 years) Pap Smear 1 per female beneficiary (>15 years) Glaucoma Screening 1 per beneficiary (>40 years) Prostate Screening 1 per male beneficiary (>40 years) HPV Vaccine 3 per beneficiary once in a lifetime - Females 9-26 years Pneumococcal Vaccine 1 per beneficiary adults (>65 years) Children \9<5 years) Flu Vaccines 1 Flu vaccination per beneficiary per year.
8 Contact Details Windhoek c/o Feld & Thorer St P.O. Box Windhoek Tel: Fax: Keetmanshoop Office Nr 12, Desert Plaza, Hampie Plichta St P.O. Box 1565 Keetmanshoop Tel: Fax: Lüderitz 230 Bismarck St P.O. Box 1178 Lüderitz Tel: Fax: Oranjemund c/o 11th Ave & 12th St P.O. Box 833 Oranjemund Tel: / 110 / 111 Fax: Oshakati The Palms 7 c/o Robert Mugabe & Main Rd P.O. Box 7196 Oshakati West Tel: Fax: Otjiwarongo Medical Centre Nr 7 Hindenberg St P.O. Box 7716 Otjiwarongo Tel: Fax: Rundu Nr 900 Old Multi-Choice Building P O Box Windhoek Tel: Fax: Rosh Pinah Unit 1 SME Park Kokerboom St P.O. Box 71 Rosh Pinah Tel: / 2130 Fax: Swakopmund c/o Tobias Hainyeko & Werf St P.O. Box 2869 Swakopmund Tel: Fax: Tsumeb 1150 Sam Nujoma Dr P.O. Box 791 Tsumeb Tel: / 2072 / 2070 Fax: / Walvis Bay Medical Park Hidipo Hamutenya St P.O. Box 731 Walvis Bay Tel: Fax: Prosperity Life Prosperity Health Member Mobile App for your benefits & claims.
Sizwe Medical Fund Benefits and Contribution 2017
Prescribed Minimum Benefits: PMBs are paid at 100% Sizwe negotiated rates except where Sizwe has a DSP arrangement in place. No co-payments apply on PMBs. Subject to pre-authorisation where applicable,
FULL BENEFIT BENEFITS GUIDE. #caring4life
FULL BENEFIT C A R E 2016 BENEFITS GUIDE #caring4life Our Full Benefit Care option offers comprehensive cover, generous benefits to cover families and individuals who need access to unlimited hospitalisation
AFFORDABLE BENEFITS GUIDE. #caring4life
AFFORDABLE C A R E 2016 BENEFITS GUIDE #caring4life Our Affordable Care option offers generous comprehensive cover with unlimited hospitalisation in any private hospital. It also covers additional chronic
S e l f N E T
2018 SelfNET 2018 What determines your decision to join a medical aid? At Selfmed we cut straight to the Is it the add-on s, you know the free gym membership and movie tickets or, is it the reliable and
Preventative care: HIV test & flu vaccine Mammogram Pap smear Pneumococcal vaccine. Prostate screening
This income based entry-level plan offers basic day-to-day benefits and hospital cover using a network of doctors, providers and hospitals. What you get Basic day-to-day benefits and GP consultations with
TAILOR-MADE ALWAYS A BETTER FIT
Unique and Tailored Benefits Emotional Wellness Support Excellent Infertility Benefits Minimum of 27 Chronic Conditions Covered No General Waiting Period Unlimited Oncology Benefits Peace of Mind TAILOR-MADE
No 10% Co-payment No waiting period No VAT. International Student Health Plan Benefit Booklet
2017 No 10% Co-payment No waiting period No VAT International Student Health Plan Benefit Booklet Contents 04 Value Add Benefits 4-5 ISS Health Plan Benefit 6 Managed Care Program 9 Additional Notes 10
20 HOSPITAL S 17 TANDARD
2017 This hospital plan offers extensive hospital benefits with some value-added benefits. Unlimited cover up to 100% in hospital 27 PMB chronic conditions covered Network specialists paid in full in hospital
60 conditions covered. R chronic benefit per family Comprehensive medicine list. Savings
BONCOMPREHENSIVE SAVINGS OPTION This first-class savings plan offers ample savings, an above threshold benefit and extensive hospital cover. In-hospital, consultations & treatment at 300% R589 000 cancer
Preventative care: HIV test & flu vaccine Mammogram Pap smear Pneumococcal vaccine. Prostate screening
What you get This traditional option uses a quality provider network to offer simple day-to-day benefits and hospital cover. 15% Cheaper than the PRIMARY OPTION R Day-to-day benefits and GP nomination
PRIMARY. Adult dependant. Main member. Child dependant R1 924 R1 505 R 613
2017 This traditional option offers simple day-to-day benefits and hospital cover. Unlimited cover up to 100% in hospital Separate benefit for GP consultations Network specialists paid in full in hospital
BONCLASSIC. Adult dependant. Child dependant. Main member R3 648 R3 132 R 900
2017 This generous savings option offers a wide range of medical benefits, in and out of hospital. Unlimited cover up to 100% in hospital Network specialists paid in full in hospital Separate benefits
20 STANDARD 17 SELECT
2017 This traditional option uses a quality provider network to offer rich day-to-day benefits and hospital cover. Unlimited cover up to 100% at hospitals on the Standard Select network Rich day-to-day
STANDARD. Adult dependant. Main member. Child dependant R2 998 R2 600 R 880
2017 This traditional option offers rich day-to-day benefits and comprehensive hospital cover. Unlimited cover up to 100% in hospital Network specialists paid in full in hospital Additional benefit for
Silver Extras Set Benefits
Your guide to Silver Extras Set Benefits 1800 640 159 Questions? Need Advice? Our consultants are available to help. Comparethemarket.com.au ACN 117 323 378 Level 2, 80 Jephson Street, Toowong Qld 4066
2016 Rochester Regional Health PPO Medical Plan Summary
Out of Annual Deductible Annual Deductible includes co-pays, coinsurance. The amounts are combined across all s. None Single Two-Person EE + Children Family $1,800 $3,600 $5,400 $5,400 Annual Out of Pocket
Baltimore City Public Schools Health Plan Comparison Chart Benefits Effective January 1, 2017
HOSPITAL INPATIENT SERVICES Baltimore City Public Schools Health Plan Comparison Chart Benefits Effective January 1, 2017 About this chart: This chart is to be used as a guide only and does not contain
Hospitalisation: - Cover at the hospital of members choice - 25% co-payment for the use of non Medshield Hospital Network no longer applicable No co-payment (Cancer Medication): - Biological Drug - Tyrosine
Standard Extras Cover Summary
Standard Extras Cover Summary Extras cover for 19 common services like Optical, General Dental and Major Dental Features Unlimited urgent ambulance by road 1 Get a fully covered flu vac and health check
20 BON CO 17 MPREHENSIVE
2017 This first-class savings plan offers ample savings, an above and extensive hospital cover. Unlimited cover up to 300% in hospital Cancer benefit of R556 700 including benefit for specialised drugs
Section 3 - Psychiatric cover (read in conjunction with Section 1)
Table of enefits HealthPlus Choice pplicable to new registrations or renewals on/or after 1 st May, 2018. This Table of enefits must be read in conjunction with your Hospital Plan Terms and Conditions
MEDICAL SCHEDULE OF BENEFITS
MEDICAL SCHEDULE OF BENEFITS Plan(s) 011 (F) All health benefits shown on this Schedule of Benefits are subject to the following: Lifetime and annual maximums, Deductibles, Co-pays, Plan Participation
Top Extras Cover Summary
Top Extras Cover Summary Top extras cover for total peace of mind Features Unlimited urgent ambulance by road 1 Get a fully covered flu vac and health check at selected Friendlies Pharmacies and Member
20 BON ESS 17 ENTIAL
2017 This hospital plan offers rich hospital benefits with some value-added benefits. Unlimited cover up to 100% in hospital 27 PMB chronic conditions covered Network specialists paid in full in hospital
Section 3 - Psychiatric cover (read in conjunction with Section 1)
Table of enefits HealthPlus Platinum pplicable to new registrations or renewals on/or after 1 st November, 2018. This Table of enefits must be read in conjunction with your Hospital Plan Terms and Conditions
Your Guide to Extras Cover
Your Guide to Extras Cover This is an important document. Please read it carefully and retain for future reference. Effective: 1 April 2018 Getting the most from your extras cover Extras cover includes
Please refer to your Benefit Handbook for further information about how your In-Network and Out-of- Network coverage works.
Schedule of Benefits The Harvard Pilgrim Health Care of New England USNH-STAFF/FACULTY POS Services listed are covered when Medically Necessary. Please see your Benefit Handbook for details. UI, 10/09
2018 Anthem Blue Cross HMO*
General Information Lifetime Maximum Benefit Annual Maximum Benefit Coinsurance Percentage 100.00% Precertification Requirements Pre-certification is required for certain services. However, this is an
2018 Anthem Blue Cross Senior Secure HMO - Southern CA - Post 65 (Medicare Eligible)*
General Information Lifetime Maximum Benefit Annual Maximum Benefit Coinsurance Percentage Precertification Requirements Prior authorization is required for select services. Services must be coordinated
Table of Benefits HealthPlus Excess
Table of enefits HealthPlus Excess pplicable to new registrations or renewals on/or after 1 st July, 2018. This Table of enefits must be read in conjunction with your Hospital Plan Terms and Conditions
Allergen specific, each allergen is covered up to 50 units per patient annually; additional units would require medically necessary review.
ALAMEDA ALLIANCE FOR HEALTH REFERRAL AND PRIOR AUTHORIZATION () GRID FOR MEDICAL BENEFITS FOR DIRECTLY CONTRACTED PROVIDERS ONLY Effective 01/01/2019 Before services are provided, please check: Member
GILSBAR GROUP HEALTH PLAN S2202 OPTION 2 NON-GRANDFATHERED PLAN BENEFIT SHEET
BENEFIT SHEET GENERAL PLAN INFORMATION Coordination of Benefits Standard COB The Plan will cover all dependent Dependents children up to age 26 Filing Limit 12 months from date of service Mailing Address
Please read this Policy Summary carefully and retain it for future reference.
1 WESTFUND POLICY SUMMARY TOP-LEVEL EXTRAS COVER SUITABLE FOR THOSE COMMITTED TO MAINTAINING A PROACTIVE AND HEALTHY LIFESTYLE. GENEROUS LIMITS ON A COMPREHENSIVE RANGE OF BENEFITS. Please read this Policy
Section 3 - Psychiatric cover (read in conjunction with Section 1)
Table of enefits pplicable to new registrations or renewals on/or after 1 st December, 2018. This Table of enefits must be read in conjunction with your Hospital Plan Terms and onditions and the directories
Preventative care: HIV test & flu vaccine. Full lipogram Mammogram Pap smear Pneumococcal vaccine. Prostate screening. Bone density screening
This first-class savings plan offers ample savings, an above threshold benefit and extensive hospital cover. What you get R R Rich savings and unlimited above threshold benefit R1 220 antenatal classes
Table of Benefits HealthPlus Extra
Table of enefits HealthPlus Extra pplicable to new registrations or renewals on/or after 1 st December, 2018. This Table of enefits must be read in conjunction with your Hospital Plan Terms and onditions
Standard Major Medical Schedule of Medical Benefits Effective June May
STANDARD HEALTH BENEFITS FOR SERVICES AND SUPPLIES PROVIDED BY KEMH, MID-ATLANTIC WELLNESS INSTITUTE AND GOVERNMENT APPROVED TESTING FACILITIES IN BERMUDA Standard Health Benefits PW OR SP OR PRIV ON YOUR
Emergency & non-emergency ambulance
Prime Living Nil excess Up to 100% Nil excess Up to 100% back for dental, optical and physiotherapy Emergency & non-emergency ambulance Generous pharmacy prescription limits Laser eye surgery cover Health
Please read this product guide in conjunction with information on our website and the Important Information Guide.
Basic Extras Effective 1 April 2018 Please read this product guide in conjunction with information on our website and the Important Information Guide. Take charge of your overall health and wellbeing with
MEDICAL & RX BENEFIT MATRIX. American Environmental Group/HSA Plan EFFECTIVE DATE: MEDICAL & RX BENEFITS
MEDICAL & RX BENEFIT MATRIX American Environmental Group/HSA Plan EFFECTIVE DATE: 01-01-2011 MEDICAL & RX BENEFITS SCHEDULE OF BENEFITS MEDICAL BENEFITS COVERED SERVICE/PLAN IN-NETWORK OUT-OF-NETWORK CATEGORY
Select Health Schedule of Medical & Dental Benefits Effective June May
STANDARD HEALTH BENEFITS FOR SERVICES AND SUPPLIES PROVIDED BY KEMH, MID-ATLANTIC WELLNESS INSTITUTE AND GOVERNMENT APPROVED TESTING FACILITIES IN BERMUDA Standard Health Benefits PW OR SP OR PRIV ON YOUR
Connecticut Teachers' Retirement Board 2019 Medicare Supplement Plan Benefits -- Administered By Stirling Benefits. General information
Provider access Covered Benefits Deductible General information All providers who accept If covers a charge, then the TRB plan covers that charge The 2019 deductible is $185. The member pays the Part B
UNIVERSITY OF THE INCARNATE WORD, S2855 BRONZE RBP PLAN GRANDFATHERED PLAN BENEFIT SHEET
BENEFIT SHEET GENERAL PLAN INFORMATION Coordination of Benefits Standard COB Dependents Children birth to 26 Filing Limit 365 days Mailing Address Remit claims to: Gilsbar, Inc., P.O. Box 2947, Covington,
Benefit Name In Network Out of Network Limits and Additional Information. Benefit Name In Network Out of Network Limits and Additional Information
BluePoint 3 Benefit Time Period: 06/01/2015-05/31/2016 Broome County - Red HMO Plan General Information Cost Sharing Expenses Deductible - Single $0 Deductible - Two Person $0 Deductible - Family $0 Services
MVP PREMIER PLUS SCHEDULE OF BENEFITS Gold 4 MVP Health Plan, Inc. Embedded Deductible Off Exchange
COST-SHARING Deductible Individual Family Prescription Drug Deductible Individual Family Out-of-Pocket Limit Individual Family OFFICE VISITS Primary Care Visits (or Home Visits) Specialist Visits (or Home
Molina Healthcare of Washington Member Services: (800) /TTY
Benefits At-A-Glance Our goal is to provide you with the best care possible. Abortion Involuntary pregnancy termination (miscarriage) Voluntary pregnancy termination Acupuncture Ambulance Transportation
MEDICAL & RX BENEFIT MATRIX. American Environmental Group/PPO Plan HSB Customer Service: EFFECTIVE DATE: MEDICAL & RX BENEFITS
MEDICAL & RX BENEFIT MATRIX American Environmental Group/PPO Plan HSB Customer Service: EFFECTIVE DATE: 01-01-2011 MEDICAL & RX BENEFITS SCHEDULE OF BENEFITS MEDICAL BENEFITS COVERED SERVICE/PLAN IN-NETWORK
Global Series Schedule of Medical & Dental Benefits Effective July May
STANDARD HEALTH BENEFITS FOR SERVICES AND SUPPLIES PROVIDED BY KEMH, MID-ATLANTIC WELLNESS INSTITUTE AND GOVERNMENT APPROVED FACILITIES IN BERMUDA Standard Health Benefits PW OR SP OR PRIV ON YOUR INSURANCE
UNIVERSITY OF THE INCARNATE WORD, S2855 PPO PLAN GRANDFATHERED PLAN BENEFIT SHEET
BENEFIT SHEET GENERAL PLAN INFORMATION Coordination of Benefits Standard COB Dependents Children birth to 26 Filing Limit 365 days Mailing Address & PPO Company Remit claims to: CIGNA Physicians & Hospitals
UNIVERSITY OF THE INCARNATE WORD, S2855 SILVER RBP PLAN GRANDFATHERED PLAN BENEFIT SHEET
BENEFIT SHEET GENERAL PLAN INFORMATION Coordination of Benefits Standard COB Dependents Children birth to 26 Filing Limit 365 days Mailing Address & PPO Company Remit claims to: Gilsbar, Inc., P.O. Box
Dental and Oral Benefit 2018
Dental and Oral Benefit 2018 Who we are Remedi Medical Aid Scheme (referred to as 'the Scheme"), registration number 1430, is a non-profit organisation, registered with the Council for Medical Schemes.
NEW YORK STATE TEAMSTERS COUNCIL HEALTH & HOSPITAL FUND APPENDIX A SCHEDULE OF BENEFITS SUPREME BENEFITS
BENEFIT GUIDE NEW YORK STATE TEAMSTERS COUNCIL HEALTH & HOSPITAL FUND APPENDIX A SCHEDULE OF SUPREME IN NETWORK FEATURES Primary Care Physician Not Required 2 Physician Referrals Not Required 2 Out of
Global Series Elite Executive Schedule of Medical & Dental Benefits Effective August May
STANDARD HEALTH BENEFITS FOR SERVICES AND SUPPLIES PROVIDED BY KEMH, MID-ATLANTIC WELLNESS INSTITUTE AND GOVERNMENT APPROVED TESTING FACILITIES IN BERMUDA Standard Health Benefits SP ON YOUR INSURANCE
Flexi Extras. Your guide to. Questions? Need Advice? Our consultants are available to help.
Your guide to Flexi Extras 1800 640 15 Questions? Need Advice? Our consultants are available to help. Comparethemarket.com.au ACN 117 33 378 Level, 80 Jephson Street, Toowong Qld 4066 PO Box 301, Toowong
Arizona Clover Health Choice PPO (040) 2019 Medical Benefits
Arizona 2019 Medical Benefits Effective Date: 1/1/2019 Version 1.0 Part D Deductible For Part D Copay information, see page 26. /year for Part D prescription drugs /year for Part D prescription drugs Out-of-Pocket
Participating Provider Non- Participating Provider Limitations & Exceptions. deductible applies. 75% of the Fund's fee schedule; deductible applies
Medical Benefits for eligible Pension Members and their eligible dependents who are not Eligible for Medicare effective 1/1/2019. NOTE $50,000.00 lifetime major medical maximum effective 1/1/2013 Out-of-network
Extras Cover Special Options
Phone 1300 13 40 60 Visit hif.com.au/extras includes all those essential services like dental, optical, podiatry, chiro, pharmacy, physio, ambulance and me. It s a step up from Saver Options, covering
II. BENEFITS AND SERVICES
II. S AND SERVICES A. HealthChoice Benefits This table shows the healthcare services and benefits that all HealthChoice enrollees can get when they need them. We offer other services not listed here. (See
Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018
Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018 Payment for Services Covered Services are reimbursed based on the Allowable Charge. Blue Cross
Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018
1 Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018 Payment for Services Covered Services are reimbursed based on the Allowable Charge. BlueCross
Your 2010 Medical Benefit Chart PFFS Plan Xerox Effective 01/01/2010
Inpatient Services Inpatient hospital care Your 2010 Medical Benefit Chart PFFS Plan Xerox Effective 01/01/2010 Hospital days are unlimited. Covered services include, but are not limited to, the following:
Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018
Schedule of Benefits Summary Group Name: Nebraska Bankers Association VEBA Effective Date: January 01, 2018 Payment for Services Covered Services are reimbursed based on the Allowable Charge. Blue Cross
SUMMARY OF P BENEFITS AND SCHEDULE OF COPAYMENTS
SUMMARY OF P-10-15-250 BENEFITS AND SCHEDULE OF COPAYMENTS THIS MATRIX IS INTENDED TO BE USED TO HELP YOU COMPARE COVERAGE BENEFITS AND IS A SUMMARY ONLY. THE EVIDENCE OF COVERAGE AND PLAN CONTRACT SHOULD
Table of Benefits One Plan Extra
Table of enefits One Plan Extra pplicable to new registrations or renewals on/or after 1 st October, 2018. This Table of enefits must be read in conjunction with your Hospital Plan Terms and onditions
AXA MANSARD PERSONAL GOLD PLAN Cover & Exclusions
This plan covers the following services; AXA MANSARD PERSONAL GOLD PLAN Cover & Exclusions EMERGENCY CARE: Initial stabilization and care, it also covers intensive care if required INTENSIVE CARE (covered
SCHEDULE OF BENEFITS PLAN M7
SCHEDULE OF BENEFITS PLAN M7 Effective September 1, 2016 All benefits, unless otherwise specified, are based on Usual, Customary and Reasonable (UCR) charges, or the network contracted amounts, and are
2018 Preventive Schedule
2018 Preventive Schedule Medicare-Covered Services PLAN YOUR CARE: KNOW WHAT YOU NEED AND WHEN TO GET IT Preventive or routine care helps us stay well or finds problems early, when they are easier to treat.
SCHEDULE OF BENEFITS PLAN C
SCHEDULE OF BENEFITS PLAN C Effective September 1, 2016 All benefits, unless otherwise specified, are based on Usual, Customary and Reasonable (UCR) charges, or the network contracted amounts, and are
NEIGHBORHOOD HEALTH PARTNERSHIP HMO SUMMARY OF BENEFITS
. (EV-4) 25/45/1000 w/access Rider NEIGHBORHOOD HEALTH PARTNERSHIP HMO SUMMARY OF BENEFITS A quick glance at this Summary of Benefits will introduce you to the important advantages of the Neighborhood
Basic Extras Cover. Effective 1 April 2017 v.2
Basic Extras Cover Effective 1 April 2017 v.2 Please carefully read and retain this brochure. Please read in conjunction with the Important Information Guide. Information in this brochure is correct at
super extras More extras than you can poke an acupuncture needle at. Your guide to
Your guide to More extras than you can poke an acupuncture needle at. The information contained in this document is current at the time of issue: September 2017 Read about what s in, what s out and what
Schedule of Benefits (REGIONAL-SEHA PRIME Plan_AL DURRA)
Plan Name Annual Benefit Limit Territorial Limit 1 REGIONAL-SEHA PPRIME Plan (AL DURRA) AED 5,000,000 Per Person Per Policy Year MENA Region* Extended to: Worldwide for (a) Emergencies (b) the Non-Elective
UnitedHealthcare SignatureValue TM Focus Offered by UnitedHealthcare of California
CALIFORNIA SMALL GROUP UnitedHealthcare SignatureValue TM Focus Offered by UnitedHealthcare of California HMO SCHEDULE OF BENEFITS PLATINUM FOCUS-2 $0 These services are covered as indicated when authorized
Jurong Medical Centre
Jurong Medical Centre JurongHealth, the public healthcare cluster formed to facilitate the integration of services and care processes for the community in the west, manages the integrated healthcare hub
Preventive Services Explained
Preventive Services Explained Medicare covers many preventive care services without charge. Most of these services have been recommended by the U.S. Preventive Services Task Force. However, which beneficiaries
ORBE Summary of Benefits
www.wellaway.com ORBE Summary of Benefits www.wellaway.com Summary of Benefits Annual Limit 5,000,000 Coinsurance ORBE 90 ORBE 100 WellAway s share of costs on a covered service Your share of costs on
Pennslyvania Green (Plan 028) 2018 Medical Benefits
Pennslyvania Green (Plan 028) 2018 Medical Benefits Effective Date: 1/1/2018 Version 1.0 Part D Deductible For Part D Copay information, see page 25. $150/year for Part D prescription drugs Tiers 1 and
Georgia Green (Plan 026) 2018 Medical Benefits
Georgia Green (Plan 026) 2018 Medical Benefits Effective Date: 1/1/2018 Version 1.0 Part D Deductible For Part D Copay information, see page 26. Out-of-Pocket Max $100/year for Part D prescription drugs
Your guide to Bupa Premier Network SECI Operatives Scheme. Effective from 1 September 2008
Effective from 1 September 2008 Your guide to Bupa Premier Network SECI Operatives Scheme This is page 1 of 8 which should be read together in full. These pages are for the summary of your Bupa membership
MetroPlus Health Plan SCHEDULE OF BENEFITS MetroPlus Gold
SECTION XXIV MetroPlus Health Plan SCHEDULE OF BENEFITS MetroPlus Gold COST-SHARING Deductible Individual Family Out-of-Pocket Limit Individual Family $0 $0 $7,150 $14,300 except as required for emergency
UNIVERSALPLAN. Efficiency Discount Option. Comprehensive Primary Care. Accessible Care Affordable Prices
2019 Comprehensive Primary Care SUBJECT TO CMS APPROVAL UNIVERSALPLAN Efficiency Discount Option Private hospital cover Choice of designated service provider Choice of benefits to suit your needs In Hospital
DATE: Dear Mr./Mrs./Ms., location.
Consultants in Pain Medicine, P.A. 5368 Fredericksburg Road Legacy Oaks Building C Ste. 210 San Antonio, Texas 78229 Phone (210) 546-1470 Fax (210) 546-1479 DATE: Dear Mr./Mrs./Ms., You have been referred
SUMMARY OF BENEFITS Your CIGNA HealthCare Indemnity plan
SUMMARY OF BENEFITS Your CIGNA HealthCare Indemnity plan Features that Add Value The CIGNA HealthCare 24-Hour Health Information Line SM connects you to registered nurses and a library of hundreds of recorded
AXA MANSARD PERSONAL PLATINUM PLUS PLAN Cover & Exclusions
AXA MANSARD PERSONAL PLATINUM PLUS PLAN Cover & Exclusions This plan covers the following services; EMERGENCY CARE: Initial stabilization and care, it also covers intensive care if required. EVACUATION:
2018 HDHP. Denver Health Medical Plan, Inc. Career Service Employees (CSE) and Denver Employee Retirement Plan (DERP) HighPoint Denver Plus Network
2018 HDHP Denver Health Medical Plan, Inc. Career Service Employees (CSE) and Denver Employee Retirement Plan (DERP) HighPoint Denver Plus Network HighPoint Denver Cofinity Network Out of Network Deductible
Long-stay patients methodology Published by NHS England and NHS Improvement
Long-stay patients methodology Published by NHS England and NHS Improvement July 2018 1 Document Title: Long-stay patients methodology Version number: 1.0 First published: 9 July 2018 Updated: Prepared
How the scheme works
Ultima Range Ultima 200 RISK S Major Medical Benefit Chronic Disease Benefit Savings How the scheme works Major Medical Benefit All costs for hospitalisation are covered from this benefit and must be preauthorised.
Anthem Blue Cross Your Plan: Premier HMO 20/200 admit/100 OP Your Network: California Care HMO
Anthem Blue Cross Your Plan: Premier HMO 20/200 admit/100 OP Your Network: California Care HMO This summary of benefits is a brief outline of coverage, designed to help you with the selection process.
Excellus BluePPO Signature Deduct 3
Excellus BluePPO Signature Deduct 3 Drug Coverage Excluded Benefit Time Period: 01/01/2017-12/31/2017 Trinity Health - Syracuse HSA General Cost Sharing Expenses - Single Domestic - $1,300 $2,500 $3,500
Organisation Type Reference Guide For use with Healthcare Identifiers Service Forms
Ambulance Services Charitable hostels for the aged Government nursing home for the aged Local government hostel for the aged Private charitable nursing home for the aged State government hostel for the
Jan 30, Dear Provider:
Jan 30, 2015 Dear Provider: Kern Health Systems strives to provide quality and timely services to our members. Recently, KHS made changes to the services included on Prior Authorization Needed list. The
SCHEDULE OF BENEFITS PLAN M7
SCHEDULE OF BENEFITS PLAN M7 Effective September 1, 2017 When you need to see a physician, a physician network, PHCS, is utilized for all physician services (primary care and specialists) and ancillary
Rehabilitation Programs
Rehabilitation Programs Inpatient and Half-Day Rehabilitation Program Information and Referral Form WELCOME TO ST LUKE S CARE Thank you for choosing St Luke s Care for your rehabilitation. With an unwavering