Routine care means medical care which is not urgent or emergent in nature and can wait for a regularly scheduled physician appointment without risk of permanent damage to the patient’s life or health status. The condition requiring routine care is not likely to substantially worsen without immediate clinical intervention.
Home care means care and treatment of an insured under a plan of care established, approved in writing and reviewed at least every 2 months by the attending physician, unless the attend- ing physician determines that a longer interval between reviews is sufficient, and consisting of one or more of the following:
Child care means continuous care and supervision of five or more qualifying children that is:
Pharmacy care means medications prescribed by a licensed physician and any health-related services considered medically necessary to determine the need or effectiveness of the medications.
Hospice Care means a coordinated program of active professional
Emergency Care means management for an illness or injury which results in symptoms which occur suddenly and unexpectedly, and requires immediate care by a medical practitioner to prevent death or serious long term impairment of the insured person’s health.
Home care services means skilled or personal care
Primary care giver" means a person who assumes the principal role of providing care and attention to a child.
Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.
In Patient Care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.
Respite care means care anticipated to be provided for a period of 28 days or less for the purpose of temporarily relieving a family member or other caregiver from his or her daily caregiv- ing duties.
Palliative care means medical service rendered to reduce or moderate temporarily the intensity of an otherwise stable medical condition, but does not include those medical services ren- dered to diagnose, heal or permanently alleviate or eliminate a medical condition.
Homemaker services means the professionally directed or supervised simple household maintenance or management services provided by trained homemakers or individuals to families in their own homes.
Outpatient services means those services rendered in a practitioner’s office or in the department of an approved facility where services are rendered to persons who have not had an overnight stay and are not charged for room and board.
Acute care means preventive care, primary care, and other medical care provided under the direction of a physician for a condition having a relatively short duration.
Medical care means amounts paid for:
Direct care means medical services, nursing services, or medically-related social services provided to a resident.
Out-of-home care means placement in a foster family home or
Managed care means a system that provides the coordinated delivery of services and supports that are necessary and appropriate, delivered in the least restrictive settings and in the least intrusive manner. Managed care seeks to balance three factors:
Health-related services means the same as in A.R.S. § 36-401.
Medically Necessary Services means those covered services that are, under the terms and conditions of the contract, determined through contractor utilization management to be: