Common use of Your PCP Must Provide, Arrange or Authorize all Medical Services Clause in Contracts

Your PCP Must Provide, Arrange or Authorize all Medical Services. Except for emergency care described in Section Five, for certain obstetric and gynecological care described in Section Four, vision care described in Section Eight, and except for dental care described in Section Nine of this contract, you are covered for the medical services listed below only if your PCP provides, arranges or authorizes the services. You are entitled to medical services provided at one of the following locations: • Your PCP's office. • Another provider's office or a facility if your PCP determines that care from that provider or facility is appropriate for the treatment of your condition. • The outpatient department of a Hospital. • As an inpatient in a Hospital, you are entitled to medical, surgical and anesthesia services.

Your PCP Must Provide, Arrange or Authorize all Medical Services. Except for emergency care described in Section Five, for certain obstetric and gynecological care described in Section Four, vision care described in Section Eight, and except for dental care described in Section Nine of this contract, you are covered for the medical services listed below only if your PCP provides, arranges or authorizes the services. You are entitled to medical services provided at one of the following locations: •  Your PCP's office. •  Another provider's office or a facility if your PCP determines that care from that provider or facility is appropriate for the treatment of your condition. •  The outpatient department of a Hospital. •  As an inpatient in a Hospital, you are entitled to medical, surgical and anesthesia services.