Emergency Room Services. This plan covers services received in a hospital emergency room or an independent freestanding emergency department when needed to evaluate, stabilize, or initiate treatment in an emergency, including ancillary services routinely available in the emergency room department or when the services are provided from other hospital departments. If your condition needs immediate or urgent, but non-emergency care, contact your PCP or use an urgent care center. This plan covers bandages, crutches, canes, collars, and other supplies incidental to your treatment in the emergency room as part of our allowance for the emergency room services. Additional services related to the emergency, including services received in other departments of the hospital may be covered separately from emergency room services and may require additional copayments. Such services may include post-stabilization services such as inpatient, outpatient or observation services, under the special circumstances described in Section 6. The amount you pay is based on the type of service being rendered. When these services are received from a non-network provider, they are covered at a network level of benefits as described in Section 6. Follow-up care services, such as suture removal, fracture care or wound care, received at the emergency room will require an additional emergency room copayment. Follow- up care services can be obtained from your primary care provider or a specialist. See Dental Services in Section 3 for information regarding emergency dental care services.
Appears in 9 contracts
Samples: Subscriber Agreement, Subscriber Agreement, Subscriber Agreement
