Urgently Needed Services means Covered Services needed to prevent a serious deterioration in a Member’s health. While not as immediate as Emergency Services, these services cannot be delayed until the Member can see a Plan Provider.
Urgently Needed Services means covered services that are not Emergency Services as defined in this section, provided when an Enrollee is temporarily absent from the Contractor’s service area when the 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 the Contractor’s Participating Providers. Such services are sometimes referred to as “urgent care.”
Urgently Needed Services means covered services that are not Emergency Services as defined in this Section, provided when an Enrollee is temporarily absent from the Contractor's service area, when the services are medically necessary and immediately required:
Examples of Urgently Needed Services in a sentence
Urgently Needed Services: The Plan will pay charges for urgently needed services outside the service area.
You can call Customer Service for information on how to access urgent care centers.Our plan covers worldwide emergency and urgent care services outside the United States under the following circumstances described in the Emergency Care and Urgently Needed Services benefits listed in the Medical Benefits Chart in Chapter 4 of this booklet.
Benefits for Covered Services received while outside the CO-OP’s Service Area are limited to Emergency Services and Urgently Needed Services when care is required immediately and unexpectedly.
Benefits for Emergency or Urgently Needed Services received from Non-Plan Providers are limited to Allowable Expenses for care required before the Member can safely receive services from a Plan Provider.
Covered Services received while outside the HPN Service Area are limited to Emergency Services and Urgently Needed Services when care is required immediately and unexpectedly.
More Definitions of Urgently Needed Services
Urgently Needed Services means Covered Services that are not emergency services as defined in 42 CFR §422.113 provided when a Member is temporarily absent from the Medicare Advantage Program Plan’s service area (or if applicable, continuation area) or, under unusual and extraordinary circumstances, Covered Services provided when the Member is in the service or continuation area but the Network is temporarily unavailable or inaccessible and when the Covered Services are Medically Necessary and immediately required as a result of an unforeseen illness, injury, or condition; and it was not reasonable, given the circumstances, to obtain the Covered Services through the Medicare Advantage Plan Network. “Stabilized Condition” means a condition whereby the physician treating the Member must decide when the Member may be considered stabilized for transfer or discharge, and that decision is binding on the Plan.
Urgently Needed Services means Covered Services needed to prevent a serious deterioration in an Insured’s health. While not as immediate as Emergency Services, these services cannot be delayed until the Insured can see a Plan Provider.
Urgently Needed Services means services for a non-life-threatening condition that requires care by a provider within twenty-four (24) hours.
Urgently Needed Services will mean medical services received outside of the Service Area which are, in the judgment of a prudent layperson, required without delay in order to prevent serious deterioration of Enrollee’s health as a result of an illness or injury.
Urgently Needed Services means Covered Services that are not emergency services as defined in 42 C.F.R. §422.113 provided when a Member/Enrollee is temporarily absent from the Medicare Advantage Program Plan’s service area (or if applicable, continuation area) or, under unusual and extraordinary circumstances, Covered Services provided when the Member is in the service or continuation area but the Network is temporarily unavailable or inaccessible and when the Covered Services are Medically Necessary and immediately required as a result of an unforeseen illness, injury, or condition; and it was not reasonable, given the circumstances, to obtain the Covered Services through the Medicare Advantage Plan Network. “Stabilized Condition” means a condition whereby the physician treating the Member must decide when the Member may be considered stabilized for transfer or discharge, and that decision is binding on the Plan.
Urgently Needed Services means Covered Services needed to prevent a serious deterioration in an Insured’s health.
Urgently Needed Services means covered services that are not emer- gency services as defined in this sec- tion, provided when an enrollee is tem- porarily absent from the MA plan’s service (or, if applicable, continuation) area (or provided when the enrollee is in the service or continuation area but the organization’s provider network is temporarily unavailable or inacces- sible) when the services are medically necessary and immediately required—