Room and Board Accommodation

The pre-assigned type of hospital room and board by Maxicare to the Member based on the benefit and coverage of the health care plan under this Agreement.

Related Condition

An illness, condition, or disease which is associated with the particular diagnosis in question either as a direct symptom or sign, a risk factor, an underlying cause, a part of a syndrome, or a complication including complications of diagnostics and treatment.

Reasonable Charges

Professional fees of non-Affiliated Physicians for services rendered to Members which do not exceed the standardized professional fees/terms of the Affiliated Physicians/Specialists. In cases where Maxicare does not have a standard professional fee for the...