Common use of PUBLIC HEALTH PLAN Clause in Contracts

PUBLIC HEALTH PLAN. With respect to a person who is a Federally Defined Eligible Individual, means any plan established or maintained by a State, the U.S. government, a foreign country, or any political subdivision of a State, the U.S. government, or a foreign country that provides health coverage to individuals who are enrolled in the plan. With respect to all other persons, Public Health Plan means any plan established or maintained by a State, the U.S. government, or any political subdivision of a State, or the U.S. government that provides health coverage to individuals who are enrolled in the plan. REFERRAL. Specific direction or instruction from a [Member]'s Primary Care Physician [or Health Center] [or Care Manager] in conformance with our policies and procedures that directs a [Member] to a Facility or Practitioner for health care. [While HMO plans typically require [Members] to get a Referral from his or her Primary Care Physician [or Care Manager] in order to use the services of a Facility or a Practitioner, this HMO plan does NOT require Members to get a Referral.] REHABILITATION CENTER. A Facility which mainly provides therapeutic and restorative services to Ill or Injured people. It must carry out its stated purpose under all relevant state and local laws, and it must either: