Common use of Organ Transplants Clause in Contracts

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement also covers: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- operative care; and • transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and Pharmacy Benefits.

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement also covers: •  obtaining donated organs (including removal from a cadaver); •  donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- operative care; and •  transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and Pharmacy Benefits.

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: •  obtaining donated organs (including removal from a cadaver); •  donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- post-operative care; and •  transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and Pharmacy Benefits.

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, -pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 3.17 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.03.11. . To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 3.11 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM TransplantsSM. For more information about the SM Blue Distinction Centers for TransplantsSM Transplants call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement agreement, we also coverscover: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- post-operative care; and • transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 3.23 - Office Visits. For surgical procedures see Section 3.35 3.34 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 3.35 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 3.27 and Pharmacy Benefits.

Organ Transplants. We cover This agreement covers transplants for heart, heart-lung, lung, liver, small intestine, -pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: •  obtaining donated organs (including removal from a cadaver); •  donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- operative care; and •  transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and Pharmacy Benefits.see

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- post-operative care; and • transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and Pharmacy Benefits.

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: •  obtaining donated organs (including removal from a cadaver); •  donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- operative care; and •  transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 - Prescription Drugs and Pharmacy Benefits.

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- operative care; and • transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 - Prescription Drugs and Pharmacy Benefits.

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational investigational – Section 8.03.13. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 3.13 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM TransplantsSM. For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement agreement, we also coverscover: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- post-operative care; and • transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 3.36 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and the Summary of Pharmacy Benefits.

Organ Transplants. We cover This agreement covers transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: •  obtaining donated organs (including removal from a cadaver); •  donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- operative care; and •  transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and Pharmacy Benefits.see

Organ Transplants. We cover This agreement covers transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- operative care; and • transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and Pharmacy Benefits.see

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.03.13. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 3.13 for the definition of experimental/investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM TransplantsSM. For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement agreement, we also coverscover: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- post-operative care; and • transportation of the organ from donor to the recipient. The amount you pay for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 - Tests, Imaging, and Labs. See the Summary of Medical Benefits for benefit limits. For prescription drugs, see Section 3.28 and the Summary of Pharmacy Benefits.

Organ Transplants. We cover transplants for heart, heart-lung, lung, liver, small intestine, -pancreas, kidney, cornea, small bowel, and bone marrow transplants. Allogenic bone marrow transplant covered health care services include medical and surgical services for the matching participant donor and the recipient. However, Human Leukocyte Antigen testing is covered as indicated in the Summary of Medical Benefits, subject to certain conditions. For details see Section 3.18 3.19 - Human Leukocyte Antigen Testing. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational – Section 8.0. To the extent that coverage for bone marrow or stem cell transplantation is more limited than the coverage required by "New Cancer Therapies”, the applicable provisions of the Rhode Island Laws shall govern. See Section 8.0 for the definition of experimental/experimental/ investigational services. The national transplant network program is called the Blue Distinction Centers for TransplantsSM . For more information about the Blue Distinction Centers for TransplantsSM call our Case Management Department at 0-000-000-0000 or 1-888-727-2300 ext. 2273. When the recipient is a covered member under this agreement we also coverscover: • obtaining donated organs (including removal from a cadaver); • donor medical and surgical expenses related to obtaining the organ that are integral to the harvesting or directly related to the donation and limited to treatment occurring during the same stay as the harvesting and treatment received during standard post- post-operative care; and • transportation of the organ from donor to the recipient. The amount you pay level of coverage for transplant services for the recipient and eligible donor is based on the type of service. For information about office visits see Section 3.24 - Office Visits. For surgical procedures see Section 3.35 3.37 - Surgery Services. For lab, radiology, and machine tests see Section 3.37 3.8 - Tests, Diagnostic Imaging, Lab, and Labs. See the Summary of Medical Benefits for benefit limitsMachine Tests. For prescription drugs, see Section 3.28 and Pharmacy Benefits.Section