May 22, 2013   TABLE OF CONTENTS   7.1.3 Payment for Services Not Covered By Medicare   With respect to any Covered Person with respect to whom Medicare is the primary payer, benefits for services that are not covered by Medicare are limited to $200,000 per calendar year. This limitation does not apply to Medicare’s deductibles, coinsurance and copays, but does apply to services that are not covered by Medicare (a) because they are explicitly excluded by Medicare, (b) services that are not covered by Medicare because they are not considered by Medicare to be medically necessary and appropriate and (c) hospital and skilled nursing facility days beyond the number of days covered by Medicare. This paragraph does not mean that the Plan covers all services not covered by Medicare. As with all medical benefits under the Plan, only services that meet the Plan’s definition of Covered Charges are covered. All applicable Plan provisions and requirements, including deductibles, copays, limitations and exclusions apply to benefits paid under this paragraph.   TABLE OF CONTENTS   St. Louis Graphic Arts Joint Health & Welfare Fund 14323 South Outer Forty Rd. - Suite S106 Chesterfield, Missouri 63017 Fund Office: (314) 878-1579 twesthues@slgahw.org Fax: (314) 275-2640   If you have any comments about this web site, please contact us at twesthues@slgahw.org.   Site Concept and Design ©2002 jWeb. Maintenance and Hosting provided by jWeb.