Services for Emergency Care. The Benefits of this plan will be provided for Emergency Services received anywhere in the world for the emergency care of an illness or injury. For Emergency Services from either a Participating Provider or a Non-Participating Provider, the Member is only responsible for the applicable Deductible, Copayment or Coinsurance as shown in the Summary of Benefits, and is not responsible for any Allowable Amount Blue Shield is obligated to pay. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encouraged to use the “911” emergency response system (where available) or seek immediate care from the nearest Hospital. For the lowest out-of-pocket expenses, covered non-Emergency Services or emergency room follow-up services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office. NurseHelp 24/7 SM The NurseHelp 24/7SM program offers Members access to registered nurses 24 hours a day, seven days a week. Registered nurses can provide assistance in answering many health-related questions, including concerns about:
Services for Emergency Care. The Benefits of this plan will be provided for Emergency Services received anywhere in the world for the emergency care of an illness or injury. For Emergency Services from either a Participating Provider or a Non-Participating Provider, the Member is only responsible for the applicable Deductible, Copayment or Coinsurance as shown in the Summary of Benefits, and is not responsible for any Allowable Amount Blue Shield is obligated to pay. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encouraged to use the “911” emergency response system (where available) or seek immediate care from the nearest Hospital. Non-Emergency Covered Services or follow-up services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office.
Services for Emergency Care. The Benefits of this Plan will be provided for Emergency Services received anywhere in the world for the emergency care of an illness or in- jury. For Emergency Services from either a Participat- ing Provider or a Non-Participating Provider, the Member is only responsible for the applicable De- ductible, Copayment or Coinsurance as shown in the Summary of Benefits, and is not responsible for any Allowable Amount Blue Shield is obli- gated to pay. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encouraged to use the “911” emergency response system (where avail- able) or seek immediate care from the nearest Hos- pital. For the lowest out-of-pocket expenses, cov- ered non-Emergency Services or emergency room follow-up services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office. NurseHelp 24/7 SM The NurseHelp 24/7 program offers Members ac- cess to registered nurses 24 hours a day, seven days a week. Registered nurses can provide assistance in answering many health-related questions, in- cluding concerns about:
Services for Emergency Care. The Benefits of this plan will be provided for Emergency Services received anywhere in the world for emergency care of an illness or injury. For Emergency Services from a provider, the Member is only responsible for the applicable Deductible, Copayment or Coinsurance as shown in the Summary of Benefits, and is not responsible for any Allowed Charges Blue Shield is obligated to pay. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encouraged to appropriately use the “911” emergency response system (where available) or seek immediate care from the nearest Hospital. Members should go to the closest Plan Hospital for Emergency Services whenever possible. The Member should notify their Personal Physician within 24 hours of receiving Emergency Services or as soon as reasonably possible following medical stabilization. An emergency means a medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in any of the following:
Services for Emergency Care. The Benefits of this Plan will be provided for covered Ser- vices received anywhere in the world for the emergency care of an illness or injury. Subscribers who reasonably believe that they have an emergency medical condition which requires an emergency response are encouraged to appropriately use the “911” emergency response system where available.
Services for Emergency Care. The Benefits of this Plan will be provided for Emergency Services received anywhere in the world for the emergency care of an illness or in- jury. For Emergency Services from either a Participat- ing Provider or a Non-Participating Provider, the Life Referrals 24/7 The Life Referrals 24/7 program offers Members access to professional counselors 24 hours a day, seven days a week for psychosocial support ser- vices. Professional Counselors can provide confi- dential telephone support, including concerns about:
Services for Emergency Care. The scope of this routine vision plan does not cover emergency services. However, Enrollees are encouraged to use appropriately the “911” emergency response system, in areas where the system is established and operating, when they have an emergency medical condition that requires an emergency response.
Services for Emergency Care. The Benefits of this Plan will be provided for covered Ser- vices received anywhere in the world for the emergency care of an illness or injury. Subscribers who reasonably believe that they have an emer- gency medical condition which requires an emergency re- sponse are encouraged to appropriately use the “911” emer- gency response system where available. Note: For the lowest out-of-pocket expenses, covered non- Emergency Services or emergency room follow-up Services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office. UTILIZATION REVIEW State law requires that health plans disclose to Subscribers and health plan providers the process used to authorize or deny health care services under the Plan. Blue Shield has completed documentation of this process (“Utilization Review”), as required under Section 1363.5 of the California Health and Safety Code. To request a copy of the document describing this Utilization Review process, call the Customer Service Department at the number listed in the back of this booklet. SECOND MEDICAL OPINION POLICY If you have a question about your diagnosis, or believe that additional information concerning your condition would be helpful in determining the most appropriate plan of treat- ment, you may make an appointment with another Physician for a second medical opinion. Your attending Physician may also offer to refer you to another Physician for a second opin- ion. Remember that the second opinion visit is subject to all Plan contract Benefit limitations and exclusions. HEALTH EDUCATION AND HEALTH PROMOTION SERVICES Health education and health promotion Services provided by Blue Shield’s Center for Health and Wellness offer a variety of wellness resources including, but not limited to: a Sub- xxxxxxx newsletter and a prenatal health education program. RETAIL-BASED HEALTH CLINICS Retail-based health clinics are Outpatient facilities, usually attached or adjacent to retail stores, pharmacies, etc., which provide limited, basic medical treatment for minor health issues. They are staffed by nurse practitioners under the di- rection of a Physician and offer services on a walk-in basis. Covered Services received from retail-based health clinics will be paid on the same basis and at the same Benefit levels as other covered Services shown in the Summary of Benefits. Retail-based health clinics may be found in the Preferred Provider Directory or the Online Physician Directory located at x...
Services for Emergency Care. The Benefits of this plan will be provided for Emergency Services received anywhere in the world for the emergency care of an illness or injury. For Emergency Services from either a Participating Provider or a Non-Participating Provider, the Member is only responsible for the applicable Deductible, Copayment or Coinsurance as shown in the Summary of Benefits, and is not responsible for any Allowable Amount Blue Shield is obligated to pay. Members who reasonably believe that they have an emergency medical condition which requires an emergency response are encouraged to use the “911” emergency response system (where available) or seek immediate care from the nearest Hospital. For the lowest out-of-pocket expenses, covered non-Emergency Services or emergency room follow-up services (e.g., suture removal, wound check, etc.) should be received in a Participating Physician’s office.
Services for Emergency Care. The Benefits of this Plan will be provided for Emergency Services received anywhere in the world for the emergency care of an illness or in- jury. For Emergency Services from either a Participat- ing Provider or a Non-Participating Provider, the Member is only responsible for the applicable De- ductible, Copayment or Coinsurance as shown in the Summary of Benefits, and is not responsible for any Allowable Amount Blue Shield is obli- gated to pay. Members who reasonably believe that they have an emergency medical condition which requires an xxx.xxxxxxxxxxxx.xxx. There is no charge for this confidential service. In the case of a medical emergency, call 911. For personalized medical advice, Members should consult with their physicians. Life Referrals 24/7 The Life Referrals 24/7 program offers Members access to professional counselors 24 hours a day, seven days a week for psychosocial support ser- vices. Professional Counselors can provide confi- dential telephone support, including concerns about:
