Common use of Emergency Health Services Clause in Contracts

Emergency Health Services. We will Cover Allowed Amounts for Emergency Health Services rendered by Participating or Non-Participating Providers. Such services must meet the requirements listed below. (A) Provided during the course of the Emergency, (B) Medically Necessary for evaluating and treating an Emergency condition, up to the point of Stabilization, and (C) Provided by or under the direction of a Provider. Health Services are not Covered if We determine that the situation was not an Emergency, as defined by this Contract. Subsequent follow-up care by Non-Participating Providers after the condition is no longer an Emergency is not Covered without Our prior written approval.