Ambulance Services. Ground Ambulance This plan covers local professional or municipal ground ambulance services when it is medically necessary to use these services, rather than any other form of transportation as required under R.I. General Law § 27-20-55. Examples include but are not limited to the following: • from a hospital to a home, a skilled nursing facility, or a rehabilitation facility after being discharged as an inpatient; • to the closest available hospital emergency room in an emergency situation; or • from a physician’s office to an emergency room. Our allowance for ground ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided. Air and Water Ambulance This plan covers air and water ambulance services when: • the time needed to move a patient by land, or the instability of transportation by land, may threaten a patient’s condition or survival; or • if the proper equipment needed to treat the patient is not available from a ground ambulance. The patient must be transported to the nearest facility where the required services can be performed and the type of physician needed to treat the patient’s condition is available. Our allowance for the air or water ambulance includes the services rendered by an emergency medical technician or paramedic, as well as any drugs, supplies and cardiac monitoring provided.
Ambulance Services a. Ambulance services provided by a local professional ground ambulance transport may be covered provided it is necessary, as determined by us, to transport you from:
Ambulance Services. Benefits are available for ambulance services provided by a licensed ambulance or psychiatric transport van. Benefits include: • Emergency ambulance transportation (surface and air) when used to transport you from the place of illness or injury to the closest medical facility that can provide appropriate medical care; and • Non-emergency, prior-authorized ambulance transportation (surface and air) from one medical facility to another. Air ambulance services are covered at the Participating Provider Cost Share, even if you receive services from a Non-Participating Provider. Clinical trials for treatment of cancer or life-threatening diseases or conditions Benefits Benefits are available for routine patient care when you have been accepted into an approved clinical trial for treatment of cancer or a life-threatening disease or condition. A life-threatening disease or condition is a disease or condition that is likely to result in death unless its progression is interrupted. The clinical trial must have therapeutic intent and the treatment must meet one of the following requirements: • Your Participating Provider determines that your participation in the clinical trial would be appropriate based on either the trial protocol or medical and scientific information provided by you; or • You provide medical and scientific information establishing that your participation in the clinical trial would be appropriate. Coverage for routine patient care received while participating in a clinical trial requires prior authorization. Routine patient care is care that would otherwise be covered by the plan if those services were not provided in connection with an approved clinical trial. The Summary of Benefits section lists your Cost Share for Covered Services. These Cost Share amounts are the same whether or not you participate in a clinical trial. Routine patient care does not include: • The investigational item, device, or service itself; • Drugs or devices not approved by the U.S. Food and Drug Administration (FDA); • Travel, housing, companion expenses, and other non-clinical expenses; • Any item or service that is provided solely to satisfy data collection and analysis needs and that is not used in the direct clinical management of the patient; • Services that, except for the fact that they are being provided in a clinical trial, are specifically excluded under the plan; • Services normally provided by the research sponsor free for any enrollee in the trial; or • Any ...
Ambulance Services. A. Benefits are available for Medically Necessary air transportation and ground ambulance services. Prior authorization by CareFirst BlueChoice is required for air ambulance services only, except for Medically Necessary air ambulance services in an emergency.
Ambulance Services. Benefits are available for ambulance services provided by a licensed ambulance or psychiatric transport van. Benefits include: • Emergency ambulance transportation (surface and air) when used to transport you from the place of illness or injury to the closest medical facility that can provide appropriate medical care; and • Non-emergency, prior-authorized ambulance transportation (surface and air) from one medical facility to another. Air ambulance services are covered at the Participating Provider Cost Share, even if you receive services from a Non-Participating Provider.
Ambulance Services. Emergency ambulance transportation by a licensed ambulance service (either ground or Air Ambulance) to the nearest Hospital where the required Emergency Health Care Services can be performed. Non-Emergency ambulance transportation by a licensed ambulance service (either ground or Air Ambulance, as we determine appropriate) between facilities only when the transport meets one of the following: • From an out-of-Network Hospital to the closest Network Hospital when Covered Health Care Services are required. • To the closest Network Hospital that provides the required Covered Health Care Services that were not available at the original Hospital. • From a short-term acute care facility to the closest Network long-term acute care facility (LTAC), Network Inpatient Rehabilitation Facility, or other Network sub-acute facility where the required Covered Health Care Services can be delivered. For the purpose of this Benefit the following terms have the following meanings: ▪ "Long-term acute care facility (LTAC)" means a facility or Hospital that provides care to people with complex medical needs requiring long-term Hospital stay in an acute or critical setting. ▪ "Short-term acute care facility" means a facility or Hospital that provides care to people with medical needs requiring short-term Hospital stay in an acute or critical setting such as for recovery following a surgery, care following sudden Sickness, Injury, or flare-up of a chronic Sickness. ▪ "Sub-acute facility" means a facility that provides intermediate care on short-term or long-term basis.
Ambulance Services. Benefits are available for Medically Necessary air and ground ambulance services as determined by CareFirst. If the Member is outside the United States and requires treatment by a medical professional, benefits will be provided to transport the Member to the nearest location where more appropriate medical care is available. Benefits include air or ground ambulance services, when Medically Necessary.
Ambulance Services. If a Covered Person is transported to a Hospital by ground ambulance from the place where an Injury occurred, or when prescribed by a Physician, eighty percent (80%) of the charges for such ground ambulance Services are payable if: (i) the Services are provided by a licensed ambulance service; and (ii) the transportation is to a Hospital capable of treating the Covered Person and which Hospital is nearest to the place of Injury or place of entering the ambulance.
Ambulance Services. Ambulance services are covered as set forth below, provided that the service is authorized in advance by a GHC Provider or meets the definition of an Emergency (see Section VIII.).
Ambulance Services a. See all exclusions.*
