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covered charges

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covered charges,
n.pl the charges for services rendered or supplies furnished by a dental professional that qualify as covered services and are paid for in whole or in part by the dental benefits program. May be subject to deductibles, copayments, coinsurance, annual or lifetime maximums, or table of allowances, as specified by the terms of the contract.


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Exhibit 5 PERCENT OF COVERED CHARGES PAID BY STATE PLANS BY NUMBER OF STATE INDEMNITY PLANS Surgical Percent and other paid by Hospital medical plan charges charges 1994 1995 1994 1995(*) 100% 19 16 11 9 90-99% 17 17 16 14 80-89% 12 15 21 23 70-79% 2 2 2 3 * Maine has a $5 copayment for medical/surgical charges.
For example, a plan that requires retirees to pay deductibles and copayments amounting to 15 percent of covered charges but no premiums may be changed to require retirees to pay 15 percent of the premium but remove deductibles and copayments.
The hospital-medical-surgical plan for employees was replaced by a "comprehensive" plan that pays 80 percent of covered charges (95 percent for hospital room and board and related charges), and has annual deductibles of $100 per person and $200 per family; a $750 per person annual limit on out-of-pocket expenses, with the plan covering the full cost for the balance of the year and all of the following year; and a $500,000 lifetime benefits limit per person.
 
 
 
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