Pregnancy Care. Treatment or services related to all care prior to delivery, delivery, post-delivery care, and any complications arising from pregnancy. Prescription Drugs – Medications, which includes Specialty Drugs, the sale or dispensing of which legally requires the order of a Physician or other health care professional and that carry the federally required product legend stipulating that such drugs may not be dispensed without a prescription, and which are currently approved by the FDA for safety and effectiveness, subject to the Limitations and Exclusions Article.
Pregnancy Care. Treatment or services related to all care prior to delivery, delivery, post-delivery care and any complications arising from pregnancy. Ectopic pregnancy and miscarriage are not considered Pregnancy Care. Since Pregnancy Care is not covered, complications of pregnancy are not covered, except for ectopic pregnancies and spontaneous abortions (miscarriages). Benefits for ectopic pregnancies and spontaneous abortions (miscarriages) are available for all covered Members under the Hospital Benefit Article and the Medical and Surgical Benefits Article of this Contract the same as any other Covered Service. Prescription Drug Formulary - A list of specific Prescription Drugs that are covered under this insurance policy. Prescription Drugs – Medications, which includes Specialty Drugs, the sale or dispensing of which legally requires the order of a Physician or other health care professional and that carry the federally required product legend stipulating that such drugs may not be dispensed without a prescription, and which are currently approved by the FDA for safety and effectiveness, subject to the Limitations and Exclusions Article. Preventive or Wellness Care – Services designed to effectively prevent or screen for a disease for which there is an effective treatment when discovered in an early stage. Private Duty Nursing Services – Services of an actively practicing Registered Nurse (RN) or Licensed Practical Nurse (LPN) who is unrelated to the patient by blood, marriage or adoption. These services must be ordered by the attending Physician and require the technical skills of an RN or LPN. Prosthetic Appliance – Appliances which replace all or part of a body organ, or replace all or part of the function of a permanently inoperative, absent or malfunctioning body part. Provider - A Hospital, Allied Health Facility, Physician, or Allied Health Professional, licensed where required, performing within the scope of license, and approved by Us. If a Provider is not subject to state or federal licensure, We have the right to define all criteria under which a Provider’s services may be offered to Our Members in order for Benefits to apply to a Provider’s Claims. Claims submitted by Providers who fail to meet these criteria will be denied.
Pregnancy Care. Contractor shall provide on-site health care services for any pregnant inmate in accordance with Idaho Jail Standards. To the extent off-site health care services are required for any pregnant inmate, Contractor shall make appropriate arrangements for rendering such care, with the cost of such off-site services being paid by County.
