Common use of Health Care Services Received Clause in Contracts

Health Care Services Received. Outside the Minnesota Advantage Health Plan’s Service Area. For covered services received by employees, former employees, and dependents outside of the Advantage service area, all care that is received within the national network of the member’s plan administrator will be covered at Benefit Level Three, with a separate out-of-area deductible. Urgent care and emergency care will be covered at Benefit Level Three whether or not the providers are within the member’s plan administrator’s national network. All other out-of-area care must be received within the given plan administrator’s national network to be covered by the plan. Referrals are not required for care received outside of the Advantage Plan’s service area.

Health Care Services Received. Outside the Minnesota Advantage Health Plan’s Service Area. For covered services received by employees, former employees, and dependents outside of the Advantage service area, all care that is received within the national network of the member’s plan administrator will be covered at Benefit Level Three, with a separate out-of-area deductible. Urgent care and emergency care will be covered at Benefit Level Three 3 whether or not the providers are within the member’s plan administrator’s national network. All other out-of-of- area care must be received within the given plan administrator’s national network to be covered by the plan. Referrals are not required for care received outside of the Advantage Plan’s service area.