Hospital Services. The Hospital will:
Hospital Services. Non-Emergency inpatient hospital services require Preauthorization. Refer to Section IV. for more information about hospital services.
Hospital Services. Coverage is only provided when in-patient hospitalization is medically necessary.
Hospital Services. Employer and Employee acknowledge that, as of the date hereof, Employer does not currently operate hospitals, hospital systems or universities. Nevertheless, the businesses of hospitals, hospital systems and universities would be the same as Employer’s Business where such hospitals, hospital systems or universities provide or contract with others to provide some or all of the medical services included in Employer’s Business. Therefore, the parties desire to clarify their intent with respect to the limitations on Employee’s ability to work for or contract with others to provide services for a hospital, hospital system or university during the Employment Period and during the Restricted Period. Section 8.1 shall not be deemed to restrict Employee’s ability to work for a hospital, hospital system or university if the hospital, hospital system or university does not provide any of the medical services included in Employer’s Business. Furthermore, even if a hospital, hospital system or university provides medical services that are included in Employer’s Business, Employee may work for such hospital, hospital system or university if Employee has no direct supervisory responsibility for or involvement in the hospital’s, hospital system’s or university’s medical services that are Employer’s Business. Finally, Employer agrees that Employee may hold direct supervisory responsibility for or be involved in the medical services of a hospital, hospital system or university that are included in Employer’s Business so long as such hospital, hospital system or university is located at least ten (10) miles from a medical practice owned or operated by Employer or its affiliate. Subject to paragraph B below, the provisions of this paragraph shall not apply to the extent that, after the date hereof, Employer enters into the business of operating a hospital or hospital system.
Hospital Services. This plan covers services you get in a hospital. At an in-network hospital, you may get services from doctors or other providers who are not in your network. When you get covered services from non-contracted providers, you pay any amounts over the allowed amount. Inpatient Care Covered services include: Room and board, general duty nursing and special diets Doctor services and visits Use of an intensive care or special care units Operating rooms, surgical supplies, anesthesia, drugs, blood, dressing, durable medical equipment and oxygen X-ray, lab and testing Outpatient Care Covered services include: Operating rooms, procedure rooms and recovery rooms Doctor services Anesthesia Services, medical supplies and drugs that the hospital provides for your use in the hospital Lab and testing services billed by the hospital and done with other hospital services This benefit does not cover: Hospital stays that are only for testing, unless the tests cannot be done without inpatient hospital facilities, or your condition makes inpatient care medically necessary Any days of inpatient care beyond what is medically necessary to treat the condition Mental Health, Behavioral Health and Substance Abuse This plan covers mental health care and treatment for alcohol and drug dependence. This plan will also cover alcohol and drug services from a state-approved treatment program. You must also get these services in the lowest cost type of setting that can give you the care you need. When medically appropriate, services may be provided in your home. This plan will comply with federal mental health parity requirements. Some services require prior authorization. See Prior Authorization for details.
Hospital Services. Hospital staff nurses, scrub nurses, standard private or semi-private room and board and other medically necessary treatments or services ordered by a physician for the Insured who is admitted to a hospital. Private nurse and standard private room upgrade to junior suite or suite are not included in Hospital Services.
Hospital Services. Enrollees shall have a choice of two (2) hospitals within the applicable time and distance standards set forth in Section 2.8.2.1.1, except that if only one (1) hospital is located within a County, the second hospital may be within a fifty (50) mile radius of the Enrollee’s ZIP code of residence; Nursing Facilities
Hospital Services. Inpatient Hospital Services. • Inpatient hospital and residential treatment facility services for mental and substance use disorders. • Outpatient hospital services, ambulatory care or surgical facility services. • Outpatient hospital, partial hospital, and rehabilitation services in a day hospital program for mental and substance use disorders. • Telemedicine. • Medically necessary genetic testing determined by PIC to be covered services, as described below: You display clinical features, or are at direct risk of inheriting the mutation in question (presymptomatic); and The result of the test will directly impact the current treatment being delivered to you; and After history, physical examination and completion of conventional diagnostic studies, a definitive diagnosis remains uncertain and a valid specific test exists for the suspected condition. 80% of eligible charges after the deductible. 50% of eligible charges after the deductible. Coverage for confinements in non- participating hospitals and non- participating residential treatment facilities are limited to a combined maximum of 120 calendar days per member per calendar year. * In the case of health care services (other than emergency services) furnished by a non-participating provider with respect to a visit at a hospital or ambulatory surgical center which is a participating provider:
Hospital Services. Medically necessary treatments or services ordered by a physician for the Insured who is admitted to a hospital.
Hospital Services. 1. Ancillary Services Benefits are payable for all ancillary services usually provided and billed for by Hospitals (except for personal convenience items) including, but not limited to, the following: Drugs and medicines provided for use while an inpatient; Use of operating or treatment rooms and equipment; Oxygen and administration of oxygen; Administration of whole blood, blood plasma and blood components when medically necessary to include the processing and preparation; and Medical and surgical dressings, casts and splints.
