Common use of Use of POWER Account Funds Clause in Contracts

Use of POWER Account Funds. Each member will be responsible for the use of funds in his or her POWER Account until the deductible is met. However, POWER Account funds can only be used by the member to pay for HIP covered services applicable to the member’s HIP benefit plan. A summary list of the HIP covered services by benefit plan is provided in Exhibit 6 of this Contract. Any service not specifically listed as a covered benefit in the applicable HIP alternative benefit plan may not be applied against the POWER Account. In spending POWER Account funds, members shall be permitted to pay for the following covered services, even if obtained through out-of-network providers: ▪ Family planning services, if obtained from a IHCP provider; ▪ Emergency medical services; ▪ Other self-referral services outlined in Section 6.2, if obtained from a IHCP provider; ▪ Medically necessary covered services, if the Contractor’s network is unable to provide the service within a 60-mile radius of the member’s residence, as specified in 42 CFR 438.206(b)(4), which addresses out-of-network coverage of necessary services, and Section 6.14; and ▪ Nurse practitioner services, if provided by an IHCP provider. Members shall not use POWER Account funds to pay for the emergency room services co- payment described in Section 6.6.2 or HIP Basic co-payments described in Section 4.1.2.

Use of POWER Account Funds. Each member will be responsible for the use of funds in his or her POWER Account until the deductible is met. However, POWER Account funds can only be used by the member to pay for HIP covered services applicable to the member’s HIP benefit plan. A summary list of the HIP covered services by benefit plan is provided in Exhibit 6 of this Contract. Any service not specifically listed as a covered benefit in the applicable HIP alternative benefit plan may not be applied against the POWER Account. In spending POWER Account funds, members shall be permitted to pay for the following covered services, even if obtained through out-of-network providers: ▪  Family planning services, if obtained from a IHCP provider; ▪  Emergency medical services; ▪  Other self-referral services outlined in Section 6.2, if obtained from a IHCP provider; ▪  Medically necessary covered services, if the Contractor’s network is unable to provide the service within a 60-mile radius of the member’s residence, as specified in 42 CFR 438.206(b)(4), which addresses out-of-network coverage of necessary services, and Section 6.14; and ▪  Nurse practitioner services, if provided by an IHCP provider. Members shall not use POWER Account funds to pay for the emergency room services co- payment described in Section 6.6.2 or HIP Basic co-payments described in Section 4.1.2.

Use of POWER Account Funds. Each member will be responsible for the use of funds in his or her POWER Account until the deductible is met. However, POWER Account funds can only be used by the member to pay for HIP covered services applicable to the member’s HIP benefit plan. A summary list of the HIP covered services by benefit plan is provided in Exhibit 6 of this Contract. Any service not specifically listed as a covered benefit in the applicable HIP alternative benefit plan may not be applied against the POWER Account. In spending POWER Account funds, members shall be permitted to pay for the following covered services, even if obtained through out-of-network providers: ▪  Family planning services, if obtained from a IHCP provider; ▪  Emergency medical services; ▪  Other self-referral services outlined in Section 6.2, if obtained from a IHCP provider; ▪  Medically necessary covered services, if the Contractor’s network is unable to provide the service within a 60-mile radius of the member’s residence, as specified in 42 CFR 438.206(b)(4), which addresses out-of-network coverage of necessary services, and Section 6.14; and ▪  Nurse practitioner services, if provided by an IHCP provider. Members shall not use POWER Account funds to pay for the emergency room services co- payment described in Section 6.6.2 or HIP Basic co-payments described in Section 4.1.2.