Urgently Needed Care definition
Urgently Needed Care or “urgent care” means those health care services that are necessary to treat a condition or illness of an individual that if not treated within twenty- four (24) hours presents a serious risk of harm.
Urgently Needed Care means Covered Services provided when a Covered Individual is either:
1.10.1 Temporarily absent from Plan's Medicare Advantage service area and such Covered Services are Medically Necessary and immediately required: (1) as a result of an unforeseen illness, injury, or condition; and (2) it was not reasonable, given the circumstances, to obtain the services through Plan's Medicare Advantage Network; or
1.10.2 Under unusual and extraordinary circumstances, the Covered Individual is in the service area but Plan's provider Network is temporarily unavailable or inaccessible and such Covered Services are Medically Necessary and immediately required: (1) as a result of an unforeseen illness, injury, or condition; and (2) it was not reasonable, given the circumstances, to obtain the services through Plan's Medicare Advantage Network.
Urgently Needed Care means the care provided to you when you are outside of the LIFE service area and you believe your illness or injury is too severe to postpone treatment until you return to the service area, but your life or function is not in severe jeopardy.
Examples of Urgently Needed Care in a sentence
If you purchase a covered Prescription Drug for medical Emergency Care or Urgently Needed Care from a Nonparticipating Pharmacy, this Plan will reimburse you for the retail cost of the drug less any required Deductible and Copayment shown in the "Schedule of Benefits" section.
Except in an emergency or Urgently Needed Care, only those pharmacies specifically identified as participating in the Ambetter Pharmacy Network may provide the Prescription Drugs benefit under this Plan.
More Definitions of Urgently Needed Care
Urgently Needed Care means any otherwise Covered Service necessary to prevent serious deterioration of the health of a Member, resulting from an unforeseen illness, injury, or complication of an existing condition, including pregnancy, for which treatment cannot be delayed until the Member is able to see his or her PCP. This includes maternity services necessary to prevent serious deterioration of the health of the Member or the Member’s
Urgently Needed Care means MA Covered Services provided when a MA Member is either: (1) temporarily absent from Plan's Medicare Advantage service area and such MA Covered Services are Medically Necessary and immediately required: (a) as a result of an unforeseen illness, injury, or condition; and (b) it was not reasonable, given the circumstances, to obtain the services through Plan's Medicare Advantage Network; or (2) under unusual and extraordinary circumstances, the MA Member is in the service area but Plan's Network is temporarily unavailable or inaccessible and such MA Covered Services are Medically Necessary and immediately required: (a) as a result of an unforeseen illness, injury, or condition; and (b) it was not reasonable, given the circumstances, to obtain the services through Plan's Medicare Advantage Network.
Urgently Needed Care means any otherwise Covered Service necessary to prevent seri-
Urgently Needed Care is when you need medical help for an unforeseen illness, injury, or condition, but your health is not in serious danger and you are generally outside of the service area. How to get urgently needed care If, while temporarily outside the Plan’s service area, you require urgently needed care, then you may get this care from any provider.
Urgently Needed Care means any otherwise Covered Service necessary to prevent seri- ous deterioration of the health of a Member, resulting from an unforeseen illness, injury, or complication of an existing condition, includ- ing pregnancy, for which treatment cannot be delayed until the Member is able to see his
Urgently Needed Care means MA Covered Services provided when a MA Member is either: (1) temporarily absent from Plan's Medicare Advantage service area and such MA Covered Services are Medically Necessary and immediately required: (a) as a result of an unforeseen illness, injury, or condition; and (b) it was not reasonable, given the circumstances, to obtain the services through Plan's Medicare Advantage Network; or