SKILLED NURSING FACILITY SERVICES. The Plan provides Benefits for Inpatient Skilled Nursing Facility services. The Plan does not cover Custodial Care. Benefits are limited to 150 days per Member per Calendar Year.
SKILLED NURSING FACILITY SERVICES. See the Prior Authorization Amendment for Covered Services that may require prior authorization.
SKILLED NURSING FACILITY SERVICES. 1. Services rendered in a Skilled Nursing Facility to the same extent benefits are available to an Inpatient of a Hospital. Benefits for Skilled Nursing Facility Services cannot exceed the Maximum number of days shown in SECTION SB - SCHEDULE OF BENEFITS of this Agreement.
SKILLED NURSING FACILITY SERVICES. Care in a skilled nursing facility will be covered on an out-of-network basis at 70% of the MAA, after the deductible is met. The provisions of Section 11.3 of the VMEP that set forth limits applicable to days of confinement for skilled nursing facility services will be deleted. (Amend the following sections of the VMEP: Sections 5.2.3 and 11.)
SKILLED NURSING FACILITY SERVICES. See Section 15, Utilization Management, for Covered Services that require prior authorization.
SKILLED NURSING FACILITY SERVICES. 1. Services rendered in a Skilled Nursing Facility to the same extent benefits are available to an Inpatient of a Hospital. Benefits for Skilled Nursing Facility Services cannot exceed the Maximum number of days shown in SECTION SB - SCHEDULE OF BENEFITS of this Agreement.
2. No benefits are payable:
a. after the Member has reached the maximum level of recovery possible for his or her particular condition and no longer requires definitive treatment other than routine supportive care;
b. when confinement in a Skilled Nursing Facility is intended solely to assist the Member with the activities of daily living or to provide an institutional environment for the convenience of a Member; and
c. for the treatment of Substance Abuse or Mental Illness. U. SPINAL MANIPULATIONS Benefits will be provided for spinal manipulations for the detection and correction by manual or mechanical means of structural imbalance or subluxation resulting from or related to distortion, misalignment, or subluxation of or in the vertebral column.
SKILLED NURSING FACILITY SERVICES. Services are limited to the following and require Precertification by the PPO in accordance with Section 2 of this Certificate: Covered Services, including room and board on a skilled bed status, in a skilled nursing facility, is covered for the first sixty (60) days of any Period of Confinement. A Period of Confinement shall be defined as the period of time from the date of admission in a skilled nursing facility to the date of discharge. With respect to a Period of Confinement, the date of admission is counted as one (1) day and the date of discharge is not counted. If a Member is discharged from a skilled nursing facility and then readmitted for the same or a related condition within six (6) months, the second admission shall be counted as a continuation of the prior Period of Confinement.
SKILLED NURSING FACILITY SERVICES. WHERE CAREFIRST BLUECHOICE PROVIDES MEMBER PAYS SKILLED NURSING FACILITY SERVICES MUST BE AUTHORIZED OR APPROVED BY CAREFIRST BLUECHOICE
SKILLED NURSING FACILITY SERVICES. 1. Hospital Services provided to an Inpatient of a Plan-approved Skilled Nursing Facility.
SKILLED NURSING FACILITY SERVICES. Skilled nursing facility services will be subject to a 120 day limit per benefit period (as defined by Medicare).
