Common use of Urgent Services Clause in Contracts

Urgent Services. Benefits will be provided for Urgent Services when Members are temporarily traveling outside of the EPO Service Area. Urgent Services are Covered Services which are Medically Necessary to prevent serious deterioration of a Member’s health resulting from unforeseen illness, injury or complications of an existing medical condition, for which treatment cannot reasonably be delayed until the Member returns to the EPO Service Area. Members should call Customer Service for assistance with finding a provider outside the Service Area. Care that does not meet the definition for Urgent Services and which could reasonably be treated within the EPO service area must be obtained from a Participating Provider. See the Out-of-Area Programs section of this Evidence of Coverage and Health Service Agreement for information specific to obtaining services outside of California. 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:

Urgent Services. Benefits will be provided for Urgent Services when Members are temporarily traveling outside of the EPO Service Area. Urgent Services are Covered Services which are Medically Necessary to prevent serious deterioration of a Member’s health resulting from unforeseen illness, injury or complications of an existing medical condition, for which treatment cannot reasonably be delayed until the Member returns to the EPO Service Area. Members should call Customer Service for assistance with finding a provider outside the Service Area. Care that does not meet the definition for Urgent Services and which could reasonably be treated within the EPO service area must be obtained from a Participating Provider. See the Out-of-of- Area Programs section of this Evidence of Coverage and Health Service Agreement for information specific to obtaining services outside of California. 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:

Urgent Services. Benefits will be provided for Urgent Services when Members are temporarily traveling outside of the EPO Service AreaCalifornia. Urgent Services are Covered Services which are Medically Necessary to prevent serious deterioration of a Member’s health resulting from unforeseen illness, injury or complications of an existing medical condition, for which treatment cannot reasonably be delayed until the Member returns to the EPO Service AreaCalifornia. Members should call Customer Service for assistance with finding a provider outside the Service Areaof California. Care that does not meet the definition for Urgent Services and which could reasonably be treated within the EPO service area must be obtained from a Participating Provider. See the Out-of-Area Programs section of this Evidence of Coverage and Health Service Agreement for information specific to obtaining services outside of California. 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:

Urgent Services. Benefits will be provided for Urgent Services when Members are temporarily traveling outside of the EPO Service AreaCalifornia. Urgent Services are Covered Services which are Medically Necessary to prevent serious deterioration of a Member’s health resulting from unforeseen illness, injury or complications of an existing medical condition, for which treatment cannot reasonably be delayed until the Member returns to the EPO Service AreaCalifornia. Members should call Customer Service for assistance with finding a provider outside the Service Areaof California. Care that does not meet the definition for Urgent Services and which could reasonably be treated within the EPO service area must be obtained from a Participating Provider. See the Out-of-Area Programs section of this Evidence of Coverage and Health Service Agreement for information specific to obtaining services outside of California. 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: