When New Members Are in a Treatment Cycle Sample Clauses

When New Members Are in a Treatment Cycle. If you are in a treatment cycle with a non- participating provider when you enroll in our plan, you may receive care from the non-participating provider up to 60 days from the date on which you started to be covered under this contract. The treatment cycle must be for a life-threatening disease or condition or a degenerative and disabling condition or disease. In addition, you can continue receiving medical care from a non-participating provider if you are in your second trimester of pregnancy when you start coverage under this contract. You can continue your medical care up to the delivery and the postpartum services directly related to your delivery. However, for you to continue receiving medical care up to 60 days or during the entire pregnancy, the non-participating provider must agree to accept our payment and to adhere to our policies and procedures, including those for guaranteeing the quality of the medical care.
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Related to When New Members Are in a Treatment Cycle

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