Common use of Transplants Clause in Contracts

Transplants. Transplants which are non-experimental or non-investigational are a Covered Benefit. Covered transplants must be ordered by the Member’s PCP and Participating Specialist Physician and pre-authorized by HMO's Medical Director. The transplant must be performed at Hospitals specifically approved and designated by HMO to perform these procedures. A transplant is non-experimental and non- investigational hereunder when HMO has determined, in its sole discretion, that the Medical Community has generally accepted the procedure as appropriate treatment for the specific condition of the Member. Coverage for a transplant where a Member is the recipient includes coverage for the medical and surgical expenses of a live donor, to the extent these services are not covered by another plan or program.

Transplants. Transplants which are non-experimental or non-investigational are a Covered Benefit. Covered transplants must be ordered by the Member’s PCP and Participating Specialist Physician and pre-authorized by HMO's ’s Medical Director. The transplant must be performed at Hospitals specifically approved and designated by HMO to perform these procedures. A transplant is non-experimental and non- investigational hereunder when HMO has determined, in its sole discretion, that the Medical Community has generally procedure is in general use and accepted the procedure as appropriate treatment for the specific condition of the Member. Coverage for a transplant where a Member is the recipient includes coverage for the medical and surgical expenses of a live donor, to the extent these services are not covered by another plan or program.