Common use of Urgent Care Clause in Contracts

Urgent Care. Urgent care services 0% - After deductible The level of coverage is the same as network provider. Vision exam - One routine eye exam per member per plan year. 0% - After deductible 40% - After deductible Non-routine eye exam 0% - After deductible 40% - After deductible Pediatric Vision Care for members under age 19: See Vision Services in Section 3 for benefit limits and details. These services only apply to an enrolled member under the age of 19: Prescription glasses - Frame and lenses 0% - After deductible Not Covered Contact lens (in lieu of prescription glasses) 0% - After deductible Not Covered Vision hardware for enrolled members aged 19 and older. Not Covered Not Covered

Urgent Care. Urgent care services 0% - After deductible The level of coverage is the same as network provider. Vision Routine vision exam - One one routine eye vision exam per member per plan year. 0% - After deductible 40% - After deductible Non-routine eye exam vision exam. 0% - After deductible 40% - After deductible Pediatric Vision Care for members under age 19: See Vision Services in Section 3 for benefit limits and details. These services only apply to an enrolled member under the age of 19: Prescription glasses - Frame and lenses 0% - After deductible Not Covered Contact lens (in lieu of prescription glasses) 0% - After deductible Not Covered Vision hardware for enrolled members aged 19 and older. Not Covered Not Covered

Urgent Care. Urgent care services 0% - After deductible The level of coverage is the same as network provider. Vision exam - One one routine eye exam per member per plan year. 0% - After deductible 40% - After deductible Non-routine eye exam 0% - After deductible 40% - After deductible Pediatric Vision Care vision care for members under age 19: See Vision Care Services in Section 3 for benefit limits and details. These services only apply to an enrolled member under the age of 19: :. Prescription glasses - Frame frame and lenses 0% - After deductible Not Covered Contact lens (in lieu of prescription glasses) 0% - After deductible Not Covered Vision hardware for enrolled members aged 19 and older. Not Covered Not Covered