Urgently Needed Care Sample Clauses

Urgently Needed Care. (This is NOT emergency care, and in most cases, is out of the service area.) 20% coinsurance, or a set copay NOT covered outside the U.S. except under limited circumstances. You pay the lesser of the Group cost share or $20 copay for each Medicare-covered urgently needed care visit.
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Urgently Needed Care. (a) In-Area Urgently Needed Care. Non-Emergency, in-area ----------------------------- Covered Medical Services obtained to treat a condition where the condition or other circumstances are such that obtaining a future appointment through standard procedures would result in severe pain or might reasonably be judged by the Beneficiary to risk a serious deterioration of the Beneficiary's health. (b) Out-of-Area Urgently Needed Care. Non-Emergency --------------------------------- Covered Medical Services obtained to treat an unforeseen condition while a Beneficiary is temporarily outside of the Medicare Risk Service Area where the condition is such that waiting to return to the service area would risk a serious deterioration of the Beneficiary's health.
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Urgently Needed Care. We will provide benefits for Urgently Needed Care provided by a Participating or a Non-Participating Provider. However, you must first call your PCP and follow his or her instructions as to what you should do. A. Urgently-Needed Care provided by a Participating Provider means Medically Necessary Covered Services to treat an illness or condition that if not treated within 24 hours presents a serious risk of harm. B. Urgently-Needed Care provided by a Non-Participating Provider means Medically Necessary Covered Services to screen and stabilize a condition that if not treated within 24 hours presents a serious risk of harm, so that you can be safely transported to a Participating Provider; provided that such services were received because you were unable to receive services from a Participating Provider. C. You, your Provider, or a member of your family must call MVP at 1-888-MVP- MBRS within 48 hours, or as soon as reasonably possible, after receiving Urgently-Needed Care that results in an inpatient admission. D. Your PCP must coordinate your care after you receive Urgently-Needed Care. E. You must pay the applicable Cost Share listed on your Schedule. You will not have to pay the Cost Share for Urgently-Needed care if you are admitted to a Hospital right away. You will have to pay the Cost Share for Hospital inpatient services.
Sample 1

Related to Urgently Needed Care

  • Urgent Care This plan covers services received at an urgent care center. For other services, such as surgery or diagnostic tests, the amount that you pay is based on the type of service being provided. See Summary of Medical Benefits for details. Follow-up care (such as suture removal or wound care) should be obtained from your

  • Chiropractic Services This plan covers chiropractic visits up to the benefit limit shown in the Summary of Medical Benefits. The benefit limit applies to any visit for the purposes of chiropractic treatment or diagnosis.

  • Health Care Operations “Health Care Operations” shall have the same meaning as the term “health care operations” in 45 CFR §164.501.

  • Child Care The County will continue to support the concept of non-profit child care facilities similar to the “Kid’s at Work” program established in the Public Works Department.

  • Mental Health Services This agreement covers medically necessary services for the treatment of mental health disorders in a general or specialty hospital or outpatient facilities that are: • reviewed and approved by us; and • licensed under the laws of the State of Rhode Island or by the state in which the facility is located as a general or specialty hospital or outpatient facility. We review network and non-network programs, hospitals and inpatient facilities, and the specific services provided to decide whether a preauthorization, hospital or inpatient facility, or specific services rendered meets our program requirements, content and criteria. If our program content and criteria are not met, the services are not covered under this agreement. Our program content and criteria are defined below.

  • Emergency Care If you need emergency care, call 911 or go to the nearest hospital emergency room. If you are traveling outside our service area and need urgent care, call the Customer Service number provided in the chart above or visit our website and use the “Find A Doctor” feature to find a BlueCard provider.

  • Clinical Management for Behavioral Health Services (CMBHS) System 1. request access to CMBHS via the CMBHS Helpline at (000) 000-0000. 2. use the CMBHS time frames specified by System Agency. 3. use System Agency-specified functionality of the CMBHS in its entirety. 4. submit all bills and reports to System Agency through the CMBHS, unless otherwise instructed.

  • Hospice Care If you have a terminal illness and you agree with your physician not to continue with a curative treatment program, this plan covers hospice care services received in your home, in a skilled nursing facility, or in an inpatient facility.

  • Plagiarism The appropriation of another person's ideas, processes, results, or words without giving appropriate credit.

  • Health Care The Company will reimburse the Executive for the cost of maintaining continuing health coverage under COBRA for a period of no more than 12 months following the date of termination, less the amount the Executive is expected to pay as a regular employee premium for such coverage. Such reimbursements will cease if the Executive becomes eligible for similar coverage under another benefit plan.

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