Emergency and Urgent Care Sample Clauses

Emergency and Urgent Care. Emergency Room After annual Part B deductible – 80% coverage of Medicare eligible expenses for the facility and doctor charges (co-insurance/co-payment waived if admitted within 1-3 days of the emergency room visit). Not covered outside the United States except under limited circumstances. Plan 65 pays the Annual Part B deductible and 20% coverage for Medicare eligible expenses. M/M Medicare and Plan 65 pay in full. No balance due. Urgi-Centers After annual Part B deductible – 80% coverage of Medicare eligible expenses for the doctor charges. Not covered outside the United States except under limited circumstances (this is not emergency care, and in most cases, is out of the service area). Plan 65 pays the annual Part B deductible and 20% coverage for Medicare eligible expenses. M/M Medicare and Plan 65 pay in full. No balance due. Inpatient Services Hospitalization Member must pay the inpatient hospital deductible and co-payment for each benefit period for Medicare eligible expenses. A benefit period begins the day the member is admitted into a hospital or skilled nursing facility. The benefit period ends when member has not received hospital or skilled nursing care for 60 days in a row. If member goes into hospital after one benefit period has ended, a new benefit period begins. There is no limit to the number of benefit periods a member can have. Days 1-60: an initial deductible of $792 (inpatient deductible). Days 61-90: $198 co-payment each day. Days 91-150 (reserve days): $396 co-payment each day. (The 60 lifetime reserve days can only be used once).) Plan 65 will pay for the inpatient hospital deductible and the co-payment for Medicare eligible expenses. Upon exhaustion of all Medicare Hospital inpatient coverage including the lifetime reserve days, member is covered up to 90% of all Medicare Part A eligible expenses for hospitalization not covered by Medicare subject to a lifetime maximum benefit of an additional 365 days. Skilled Nursing Care and custodial care are not covered. Days 1-60: an initial deductible of $792 (inpatient deductible). Days 61-90: $198 co-payment each day. Days 91-150: (reserve days): $396 co- payment each day. (The 60 lifetime reserve days can only be used once.) M/M Not applicable. Skilled Nursing Member is responsible for each hospitalization benefit period, following at least 3-day covered hospital stay. There is a limit of 100 days for each benefit period. Must be a Medicare certified skilled nursing facility to receive...
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Emergency and Urgent Care. Provider agrees to abide by the terms of the State Contract for the timely provision of emergency and urgent care. Where applicable, Provider agrees to follow those procedures for handling urgent and emergency care cases stipulated in any required hospital/emergency room MOUs signed by United in accordance with the State Contract.
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Emergency and Urgent Care. The copay for In Network urgent care center visits will be $20. The copay for In Network hospital emergency room visits will be $100. There will be no charge for In Network ambulance services, if medically necessary. The coinsurance for Out of Network emergency room, urgent care, and ambulance services will be 20% of the allowed benefit, after the Out of Network annual deductible. Diagnostic, X-ray, and Laboratory Services: The copay for In Network diagnostic services, x-rays, and laboratory tests will be $10. The copay for allergy shots, as well as physical, occupational, and speech therapy will be $20. The copay for In Network chiropractor services will be $30. The coinsurance for Out of Network diagnostic, x-ray, and laboratory services will be 20% of the allowed benefit, after the Out of Network annual deductible.
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Emergency and Urgent Care. Emergency Room After annual Part B deductible – 80% coverage of Medicare eligible expenses for the facility and doctor charges (co-insurance/co-payment waived if admitted within 1-3 days of the emergency room visit). Not covered outside the United States except under limited circumstances. Plan 65 pays the Annual Part B deductible and 20% coverage for Medicare eligible expenses. M/M Medicare and Plan 65 pay in full. No balance due. Urgi-Centers After annual Part B deductible – 80% coverage of Medicare eligible expenses for the doctor charges. Not covered outside the United States except under limited circumstances (this is not emer- gency care, and in most cases, is out of the service area). Plan 65 pays the annual Part B deductible and 20% coverage for Medicare eligible expenses. M/M Medicare and Plan 65 pay in full. No balance due.
Sample 1
Emergency and Urgent Care. The PO is responsible to provide care according to the requirements in 42 C.F.R. § 460.100.
Sample 1
Emergency and Urgent Care. Emergency Care provided by Provider shall be available to Covered Persons twenty-four (24) hours, seven (7) days a week. Urgent care services shall be provided within forty-eight (48) hours of receipt of the request for Urgent Care services.
Sample 1

Related to Emergency and Urgent Care

  • Urgent Care This plan covers services received at an urgent care center. For other services, such as surgery or diagnostic tests, the amount that you pay is based on the type of service being provided. See Summary of Medical Benefits for details. Follow-up care (such as suture removal or wound care) should be obtained from your primary care provider or specialist.

  • Emergency Services The parties recognize that in the event of a strike or lockout, situations may arise of an emergency nature. To this end, the Employer and the Union will agree to provide services of an emergency nature.

  • Emergency Care If you need emergency care, call 911 or go to the nearest hospital emergency room. If you are traveling outside our service area and need urgent care, call the Customer Service number provided in the chart above or visit our website and use the “Find A Doctor” feature to find a BlueCard provider.

  • Emergency Services Leave 6.17.1 Subject to operational requirements, paid leave of absence shall be granted by the Employer to an Employee who is an active volunteer member of State Emergency Service, St Xxxx Ambulance Brigade, Volunteer Fire and Rescue Service, Xxxx Fire Brigades, Volunteer Marine Rescue Services Groups or FESA Units, in order to allow for attendances at emergencies as declared by the recognised authority.

  • Emergency Situations If the condition is an emergency, this will be communicated to the Contractor with the request that corrections are to be accomplished immediately. The Contractor shall respond to the notice in emergency situations within twenty-four hours. If the Contractor fails to respond within this time limit, the Owner may correct the defect and charge the Contractor for the Work. If it is determined the complaint is not the responsibility of the Contractor, the Contractor shall be promptly paid for the cost of the corrective work. The Contractor shall give notice in writing to the Owner when corrections have been completed.

  • Emergency Situation In the event of an emergency situation beyond our reasonable control, such as an "act of God," war, fire, or natural disaster, services involving your account could be available only in a modified or reduced form or could be entirely unavailable. Unless expressly prohibited by applicable law, you agree that we will have no liability to you for such modification, reduction, or unavailability of services caused by an emergency situation.

  • Patient Care Resident shall participate in safe, effective, and compassionate patient care, under supervision, commensurate with Resident's level of advancement and responsibility.

  • Emergency Response Partners must develop, maintain, and carry out a response plan for public water system emergencies, including disease outbreaks, spills, operational failures, and water system contamination. Partners must notify DWS in a timely manner of emergencies that may affect drinking water supplies.

  • Emergency Service Leave Where employees' services are required for emergency operations by request from Provincial Emergency Programs or appropriate police authority, leave from work as required may be granted without loss of basic pay. If any remuneration, other than for expenses, is received, it shall be remitted to the Employer.

  • Emergency Access Landlord shall have the right to enter the Premises at any time without notice in the event of an emergency.

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