24 Comprehensive Medical Coverage The Plan will pay medical benefits as set forth in this SPD for covered medical charges incurred by you, your Spouse, or your Eligible Dependent C hildren while eligible for medical benefits under the Plan. Medical Benefit A Medical Benefit is the amount, if any, the Plan will pay for covered medical charges incurred by you, your Spouse, or your Eligible Dependent Child. The amount of a medical bene fit is the amount the Claims Administrator calculates in the steps shown below: • The charges for which a claim is submitted to the Claims Administrator are tested against the covered medical charge definition. The submitted charges that meet all of the te sts are the covered medical charges under the Plan. • Any copay ment amount that applies to the charges is subtracted from the amount of covered medical charge s. • If any part of the remaining amount exceeds an applicable benefit maximum, then that part is subt racted and the remainder is the amount of the medical benefit. Medically Necessary Charges Plan benefits are payable for charges incurred only to the extent the charges are for services, supplies and treatments that are medically necessary as defined under the terms of the Plan, and only up to the applicable maximum allowed for such benefits, services, or supplies under the terms of the Plan. Certain services are not subject to the medically necessary definition, as noted in the SPD . Deductible This Plan does not have a deductible before it covers expenses. Copayment A Copayment is the amount a participant must pay to his or her provider of service before benefits are payable by the Plan. The copayment shown in the Schedule of Benefits: • Applie s to all covered medical charges unless otherwise stated; • Applies separately to each participant ; and • Applies separately for each visit, stay, procedure or item unless otherwise stated . No charge will be subject to more than one copayment amount. Coinsurance Coinsurance under this Plan applies only to prescription drugs. The coinsurance referenced in the Schedule of Benefits is the patient percentage of Covered Prescription Drug Charges for which you are responsible after the Plan’s payment (e.g. i f the Plan pays 8 0% of a covered Prescription Drug , your coinsurance is the remaining 2 0% . Your coinsurance: • Is payable when your CVS Caremark network pharmacy fills your prescription ; and • Does not include expenses not covered by the Plan . Payment Percentage The Payment Percentage and the covered medical charges to which such Payment Percentage applies are shown in the detailed Schedule of Benefits. The Payment Percentage applies after any applicable copayment amount has been met, and it is applied separately to each covered individual.