Common use of Emergency or Urgently Needed Services Clause in Contracts

Emergency or Urgently Needed Services. Emergency Services obtained from Non-Plan providers will be payable at the same benefit level as would be applied to care received from Plan Providers. Benefits are limited to Eligible Medical Expenses for Non-Plan Provider Emergency Services as defined under “HPN Reimbursement Schedule”. You are responsible for any Non-Plan Provider Emergency Service charges that exceed payments made by HPN. Benefits for Emergency Services are subject to any limit shown in the Attachment A Benefits Schedule. Examples of conditions which require Medically Necessary treatment, but are not Emergency Services, include:  Sore throats.  Flu or fever.  Earaches.  Sore or stiff muscles.  Sprains, strains or minor cuts.  Suture removal.  Routine dental services.  Medication refills.

Emergency or Urgently Needed Services. Emergency Services obtained from Non-Plan providers will be payable at the same benefit level as would be applied to care received from Plan Providers. Benefits are limited to Eligible Medical Expenses for Non-Plan Provider Emergency Services as defined under “HPN Reimbursement Schedule”. You are responsible for any Non-Plan Provider Emergency Service charges that exceed payments made by HPN. Benefits for Emergency Services are subject to any limit shown in the Attachment A Benefits Benefit Schedule. Examples of conditions which require Medically Necessary treatment, but are not Emergency Services, include:  Sore throats.  Flu or fever.  Earaches.  Sore or stiff muscles.  Sprains, strains or minor cuts.  Suture removal.  Routine dental services.  Medication refills.

Emergency or Urgently Needed Services. Emergency Services obtained from Non-Plan providers will be payable at the same benefit level as would be applied to care received from Plan Providers. Benefits are limited to Eligible Medical Expenses Expenses, or the Recognized Amount when applicable, for Non-Plan Provider Emergency Services as defined under “HPN Reimbursement Schedule”. You are responsible for any Non-Plan Provider Emergency Service charges that exceed payments made by HPN. Benefits for Emergency Services are subject to any limit shown in the Attachment A Benefits Benefit Schedule. Examples of conditions which require Medically Necessary treatment, but are not Emergency Services, include:  Sore throats.  Flu or fever.  Earaches.  Sore or stiff muscles.  Sprains, strains or minor cuts.  Suture removal.  Routine dental services.  Medication refills.