Non-emergency services. No benefit will be payable with respect to non-emergency, experimental or elective services, including any Treatment, surgery or medication which medical evidence indicates that the Insured Person could have returned to Canada to receive.
Non-emergency services. If you are traveling outside of the Ambetter of Illinois insured by Celtic Insurance Company service area you may be able to access providers in another state if there is an Ambetter plan located in that state. You can locate Ambetter providers outside of Illinois by searching the relevant state in our Provider Directory at Xxxxx.XxxxxxxxXxxxxx.xxx. Not all states have Ambetter plans. If you receive care from an Ambetter provider outside of the service area, you may be required to receive prior authorization for non-emergency services. Contact Member Services at the phone number on your member identification card for further information.
Non-emergency services. If you go to an emergency room for what is not an emergency medical condition, the plan may not cover your expenses. See the schedule of benefits for more information.
Non-emergency services. Non-emergency, experimental or elective treatment (e.g. cosmetic treatment, regular care of a chronic medical condition or any treatment or surgery that is not required for relief of acute pain or suffering).
Non-emergency services. If you go to an emergency room for what is not an emergency medical condition, the plan may not cover your expenses. See the schedule of benefits for this information. Orthotic devices Covered services include the initial orthotic device and subsequent replacement that your physician orders and administers to support or brace weak or ineffective joints or muscles of the foot. We will cover the same type devices that are covered by Medicare. Your provider will tell us which device best fits your need. But we cover it only if we preauthorize the device. Orthotic device means a customized medical device applied to a part of the body to: • Correct a deformity • Improve function • Relieve symptoms of a disease Coverage Includes: • Repairing or replacing the original device. Examples of these are: ‒ Repairing or replacing the original device you outgrow or that is no longer appropriate because your physical condition changed ‒ Replacements required by ordinary wear and tear or damage • Instruction and other services (such as attachment or insertion) so you can properly use the device. Habilitation therapy services Habilitation therapy services help you keep, learn, or improve skills and functioning for daily living (e.g. therapy for a child who isn’t walking or talking at the expected age). The services must follow a specific treatment plan, ordered by your physician. The services have to be performed by a: • Licensed or certified physical, occupational, or speech therapist • Hospital, skilled nursing facility, or hospice facility • Home health care agency • Physician Outpatient physical, occupational, and speech therapy Covered services include: • Physical therapy if it is expected to develop any impaired function • Occupational therapy if it is expected to develop any impaired function • Speech therapy if it is expected to develop speech function that resulted from delayed development (Speech function is the ability to express thoughts, speak words and form sentences.) The following are not covered services: • Services provided in an educational or training setting or to teach sign language • Vocational rehabilitation or employment counseling Hearing aid and cochlear implants and related services Covered services include hearing aids or cochlear implants and the following related services and supplies: • Fitting and dispensing services and ear molds necessary to maintain optimal fit of hearing aids • Treatment related to hearing aids and cochlear implants, inc...
Non-emergency services. Fairchild will prepare a bid for the services to be rendered. If it accepts the bid, National will issue a Purchase Order.
Non-emergency services. If you go to an emergency room for what is not an emergency medical condition, the plan may not cover your expenses. See the schedule of benefits for this information. Foot orthotic devices Covered services include a mechanical device or special footwear, ordered by your physician, to support or brace weak or ineffective joints or muscles of the foot. Gender affirming treatment Covered services include services and supplies for gender affirming (sometimes called sex change) treatment. Important note: Visit xxxxx://xxx.xxxxx.xxx/health-care-professionals/clinical-policy-bulletins.html for detailed information about this benefit, including eligibility and medical necessity requirements. You can also call the toll-free number on your ID card. Habilitation therapy services Habilitation therapy services help you keep, learn, or improve skills and functioning for daily living (e.g. therapy for a child who isn’t walking or talking at the expected age). The services must follow a specific treatment plan, ordered by your physician. The services have to be performed by a: • Licensed or certified physical, occupational, or speech therapist • Hospital, skilled nursing facility, or hospice facility • Home health care agency • Physician Outpatient physical, occupational, and speech therapy Covered services include: • Physical therapy if it is expected to develop any impaired function • Occupational therapy if it is expected to develop any impaired function • Speech therapy if it is expected to develop speech function that resulted from delayed development (Speech function is the ability to express thoughts, speak words and form sentences.) The following are not covered services: • Services provided in an educational or training setting or to teach sign language • Vocational rehabilitation or employment counseling Home health care Covered services include home health care provided by a home health care agency in the home, but only when all of the following criteria are met: • You are homebound • Your physician orders them • The services take the place of a stay in a hospital or a skilled nursing facility, or you are unable to receive the same services outside your home • The services are a part of a home health care plan • The services are skilled nursing services, home health aide services or medical social services, or are short-term speech, physical or occupational therapy • Home health aide services are provided under the supervision of a registered nurse • Medical s...
Non-emergency services. Services provided to an enrollee who has presentation of medical signs and symptoms to a health care provider.
Non-emergency services. Therapist self-care is vital to ensure the highest quality of care is provided to our clients. It is important that you be aware that therapists will not answer emails or phone calls after hours or on the weekends. We are an outpatient practice and therefore do not provide emergency psychotherapeutic services or transportation to/from the hospital. The therapists at The Mariposa Center provide non-emergency services during stated business hours and by scheduled appointment only. Therapists will return calls during stated business hours only. If you must seek after hours treatment from any counseling agency or center, emergency room, or hospital, you understand that you remain solely responsible for any fees that arise from that care. (Initial)
