Medicare The Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965 as then constituted or later amended. Medicare Eligible Expenses Expenses that are covered by to the extent recognized as reasonable and necessary by Medicare (See your handbook for details.) Medicare. Medicare Member You, the person who has the right to the benefits described in this Benefit Description. A is enrolled as the in this Medex plan. member subscriber Mental or Nervous Conditions Psychiatric illnesses or diseases. include drug addiction and alcoholism.) The illnesses or diseases that qualify as are listed in the latest edition, at the time mental or nervous conditions you receive treatment, of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Outpatient A patient who is not a registered bed patient in a facility. For example, a patient at a health center, provider's office, surgical day care unit or ambulatory surgical facility is considered an A patient who is kept overnight in a solely for observation is also considered outpatient. hospital an This is true even though the patient uses a bed. outpatient. Physician A as defined by or a person licensed as a by the appropriate physician Medicare, physician jurisdiction where he or she is located. Medex provides benefits as described in this Benefit Description for services that are physician covered by Medex only. This means that does not make any payment for these Medicare services. Plan Sponsor The is usually your employer and is the same as the plan sponsor designated under plan sponsor the Employee Retirement Income Security Act of 1974 (ERISA), as amended. If you are not sure who your is, contact your employer. plan sponsor Room and Board Your room, and general nursing services while you are an This includes inpatient. hospital services furnished in an intensive care or similar unit.
Medicare The Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965 as then constituted or later amended. Medicare Eligible Expenses Expenses that are covered by Medicare to the extent recognized as reasonable and necessary by Medicare. (See your Medicare handbook for details.) Member You, the person who has the right to the benefits described in this Benefit Description. A member is enrolled as the subscriber in this Medex plan. Mental or Nervous Conditions Psychiatric illnesses or diseases. include drug addiction and alcoholism.) The illnesses or diseases that qualify as mental or nervous conditions are listed in the latest edition, at the time you receive treatment, of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. Outpatient A patient who is not a registered bed patient in a facility. For example, a patient at a health center, provider's office, surgical day care unit or ambulatory surgical facility is considered an outpatient. A patient who is kept overnight in a hospital solely for observation is also considered an outpatient. This is true even though the patient uses a bed. Physician A physician as defined by Medicare, or a person licensed as a physician by the appropriate jurisdiction where he or she is located. Medex provides benefits as described in this Benefit Description for physician services that are covered by Medex only. This means that Medicare does not make any payment for these services. Plan Sponsor The plan sponsor is usually your employer and is the same as the plan sponsor designated under the Employee Retirement Income Security Act of 1974 (ERISA), as amended. If you are not sure who your plan sponsor is, contact your employer. Room and Board Your room, and general nursing services while you are an inpatient. This includes hospital services furnished in an intensive care or similar unit.
ascme2-0601.docx