Common use of Complications of Pregnancy Clause in Contracts

Complications of Pregnancy. Benefits are provided for complications of pregnancy resulting from conditions requiring Hospital confinement when the pregnancy is not terminated and whose diagnoses are distinct from pregnancy but are adversely affected by pregnancy or are caused by pregnancy. Benefits for a normal or difficult delivery are not covered under this provision. Such benefits are determined solely by the Maternity Care section of this Contract. In-network and out-of-network cost-sharing apply accordingly. CONSULTATION SERVICES Covered when the special skill and knowledge of a consulting Physician is required for the diagnosis or treatment of an illness or Injury. DIABETES We cover Medically Necessary equipment, supplies, pharmacological agents, and outpatient self-management training and education, including nutritional therapy for individuals with insulin-dependent diabetes, insulin-using diabetes, gestational diabetes, and non-insulin-using diabetes as prescribed by the Physician. Covered Services for outpatient self-management training and education must be provided by a certified, registered or licensed health care professional with expertise in diabetes.

Complications of Pregnancy. Benefits are provided for complications Complications of pregnancy Pregnancy resulting from conditions requiring Hospital confinement when the pregnancy is not terminated and whose diagnoses are distinct from pregnancy but are adversely affected by pregnancy or are caused by pregnancy. Benefits for a normal or difficult delivery are not covered under this provision. Such benefits are determined solely by the Maternity Care section of this Contract. In-network Network and outOut-of-network cost-Network cost sharing apply accordingly. CONSULTATION SERVICES Covered when the special skill and knowledge of a consulting Physician is required for the diagnosis or treatment of an illness or Injury. DIABETES We cover Medically Necessary equipment, supplies, pharmacological agents, and outpatient self-management training and education, including nutritional therapy for individuals with insulin-dependent diabetes, insulin-using diabetes, gestational diabetes, and non-insulin-using diabetes as prescribed by the Physician. Covered Services for outpatient self-management training and education must be provided by a certified, registered or licensed health care professional with expertise in diabetes.