Observation Services. In a hospital or other health care facility 10% - After deductible Not Covered Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Care Coordinated by Your Primary Care Provider and permitted Self-Referrals Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay
Appears in 3 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
Observation Services. In a hospital or other health care facility 10% - After deductible Not Covered Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Care Coordinated by Your Primary Care Provider and permitted Self-Referrals Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay
Appears in 2 contracts
Samples: Subscriber Agreement, Subscriber Agreement
Observation Services. In a hospital or other health care facility 100% - After deductible Not Covered Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Care Coordinated by Your Primary Care Provider and permitted Self-Referrals Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay
Appears in 1 contract
Samples: Subscriber Agreement
Observation Services. In a hospital or other health care facility 10Standard 0% - After deductible Not Covered Enhanced 0% Not Covered Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Care Coordinated by Your Primary Care Provider and permitted Self-Referrals Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay
Appears in 1 contract
Samples: Subscriber Agreement