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Intensive Care Sample Clauses

Intensive CareCardiac care unit or other unit or area of a Hospital that meets the required standards of the Joint Commission on Accreditation of Hospitals for Special Care Units. Intoxicated: A blood alcohol level which equals or exceeds the legal limit for operating a motor vehicle in the state or jurisdiction where you are located at the time of an incident. Master Policy of Insurance: That certain group insurance policy No. RCB07421 issued to World Commercial Trust Medical Emergency: Occurrence of a Sickness, Illness, Injury, or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including severe pain that an individual could reasonably expect the absence of immediate medical attention to result in (i) placing the health of the person afflicted with such condition in serious jeopardy or, in the case of a behavioral condition, placing the health of such person or others in serious jeopardy; (ii) serious impairment to such person's bodily functions; (iii) serious dysfunction of any bodily organ or part of such person; or (iv) serious disfigurement of such person. Additionally, a Medical Emergency will include visits where the only option for necessary immediate care is an emergency room.
Intensive Care. Xx. Xxxxx-
Intensive Care. General Renal Intensive Care – Neonatal Stomal Therapy Midwifery
Intensive Care. 97.1.10.1.9 Medi-Cal documentation, 8 chart review and audits.
Intensive Care. Unit Hospital unit required for patients with critical health conditions and who need life support of organic functions beside special medical supervision and constant monitoring. Intensive Outpatient Programs (IOP) Program that provides intensive treatment and support for the treatment of some conditions such as, depression and anxiety disorders, and substance dependence not requiring detoxification. Internal Appeal Request for revision of an adverse determination of benefits or of the result of the investigation of a complaint before the plan or insurer. Main Insured certificate with the insurance company. Maintenance Drugs Maintenance drugs are those whose most common use is treating chronic diseases. Therapy with this medication is not considered curative. Maintenance drugs are administered continuously (for over ninety (90) days) instead of intermittently. Marriage Marriage is a civil institution that originates with a civil contract in which the contracting parties mutually agree to become spouses and follow the duties imposed by the law, as applicable, in the United States and its territories. It is valid only when it is contracted and solemnized according to the provisions of law, and may be dissolved before the death of any of the spouses only in cases as expressly provided by law. Maximum Out-of- Pocket or MOOP Maximum amount of money that an insured has to pay during a period of benefits in addition to the premium before the insurance company pays one- hundred percent (100%) of the services covered under this certificate. MCS Life Clinical Affairs MCS Life department that groups the following units: Pre-authorization, Hospital Review, Education and Wellbeing, Managed Care and Care Transition. Medical Emergency Condition in which the symptoms presented are severe enough for a reasonable and prudent person with average health and medical knowledge to reasonably conclude that the absence of immediate medical care could result in: putting at risk the health of a person or the health of an unborn child, a serious impairment to body functions, or serious dysfunction of any body part or organ. Medical necessity Care, service or supply generally accepted by the medical community as effective, appropriate, and essential to diagnose and treat an illness or injury, and that: Is based on generally accepted or recognized standards of care and that are appropriate for the symptoms, diagnosis and treatment of an injury, condition or illness, and for direct car...

Related to Intensive Care

  • Hospice Individuals whose permanent residence and principal work location are outside the State of Minnesota and outside of the service areas of the health plans participating in Advantage. If these individuals use the plan administrator’s national preferred provider organization in their area, services will be covered at Benefit Level Two. If a national preferred provider is not available in their area, services will be covered at Benefit Level Two through any other provider available in their area. If the national preferred provider organization is available but not used, benefits will be paid at the POS level described in paragraph “i” below. All terms and conditions outlined in the Summary of Benefits will apply.

  • Hospice Care If you have a terminal illness and you agree with your physician not to continue with a curative treatment program, this plan covers hospice care services received in your home, in a skilled nursing facility, or in an inpatient facility.

  • Preventive Care This plan covers preventive care as described below. “

  • Chiropractic Services This plan covers chiropractic visits up to the benefit limit shown in the Summary of Medical Benefits. The benefit limit applies to any visit for the purposes of chiropractic treatment or diagnosis.

  • Ambulance The deductible and coinsurance for services not subject to copays applies.

  • Outpatient Dental Anesthesia Services This plan covers anesthesia services received in connection with a dental service when provided in a hospital or freestanding ambulatory surgical center and: • the use of this is medically necessary; and • the setting in which the service is received is determined to be appropriate. This plan also covers facility fees associated with these services. This plan covers dental care for members until the last day of the month in which they turn nineteen (19). This plan covers services only if they meet all of the following requirements: • listed as a covered dental care service in this section. The fact that a provider has prescribed or recommended a service, or that it is the only available treatment for an illness or injury does not mean it is a covered dental care service under this plan. • dentally necessary, consistent with our dental policies and related guidelines at the time the services are provided. • not listed in Exclusions section. • received while a member is enrolled in the plan. • consistent with applicable state or federal law. • services are provided by a network provider.

  • Orthodontics We Cover orthodontics used to help restore oral structures to health and function and to treat serious medical conditions such as: cleft palate and cleft lip; maxillary/mandibular micrognathia (underdeveloped upper or lower jaw); extreme mandibular prognathism; severe asymmetry (craniofacial anomalies); ankylosis of the temporomandibular joint; and other significant skeletal dysplasias.

  • Prosthodontics We Cover prosthodontic services as follows:

  • Wellness i. To support the statewide goal for a healthy and productive workforce, employees are encouraged to participate in a Well-Being Assessment survey. Employees will be granted work time and may use a state computer to complete the survey. ii. The Coalition of Unions agrees to partner with the Employer to educate their members on the wellness program and encourage participation. Eligible, enrolled subscribers who register for the Smart Health Program and complete the Well-Being Assessment will be eligible to receive a twenty-five dollar ($25) gift certificate. In addition, eligible, enrolled subscribers shall have the option to earn an annual one hundred twenty-five dollars ($125.00) or more wellness incentive in the form of reduction in deductible or deposit into the Health Savings Account upon successful completion of required Smart Health Program activities. During the term of this Agreement, the Steering Committee created by Executive Order 13-06 shall make recommendations to the PEBB regarding changes to the wellness incentive or the elements of the Smart Health Program.

  • Hospital This plan covers behavioral health services if you are inpatient at a general or specialty hospital. See Inpatient Services in Section 3 for additional information. This plan covers services at behavioral health residential treatment facilities, which provide: • clinical treatment; • medication evaluation management; and • 24-hour on site availability of health professional staff, as required by licensing regulations. This plan covers intermediate care services, which are facility-based programs that are: • more intensive than traditional outpatient services; • less intensive than 24-hour inpatient hospital or residential treatment facility services; and • used as a step down from a higher level of care; or • used a step-up from standard care level of care. Intermediate care services include the following: • Partial Hospital Program (PHP) – PHPs are structured and medically supervised day, evening, or nighttime treatment programs providing individualized treatment plans. A PHP typically runs for five hours a day, five days per week. • Intensive Outpatient Program (IOP) – An IOP provides substantial clinical support for patients who are either in transition from a higher level of care or at risk for admission to a higher level of care. An IOP typically runs for three hours per day, three days per week.