Radiation Therapy/Chemotherapy Services Sample Clauses

Radiation Therapy/Chemotherapy Services. This plan covers chemotherapy and radiation services. Respiratory Therapy This plan covers respiratory therapy services. When respiratory services are provided in your home, as part of a home care program, durable medical equipment, supplies, and oxygen are covered as a durable medical equipment service.
Radiation Therapy/Chemotherapy Services. If you are dispensed a specialty prescription drug from a Rhode Island network provider, the charge for the specialty prescription drug is not reimbursed and the Rhode Island network provider may not seek reimbursement from you. If you are dispensed a specialty prescription drug from a non-network provider or by a provider that participates with an out of state Blue Cross and Blue Shield plan, the charge for the specialty prescription drug is not reimbursed. You are liable to pay the for the specialty prescription drug. Prescription drugs are reimbursed based on the type of service and the site of service. See the Summary of Pharmacy Benefits for benefit limits and the amount that you pay.
Radiation Therapy/Chemotherapy Services. Outpatient 0% - After deductible 40% - After deductible In a physician’s office 0% - After deductible 40% - After deductible Respiratory Therapy Inpatient 0% - After deductible 40% - After deductible Outpatient 0% - After deductible 40% - After deductible Skilled Care in a Nursing Facility* Skilled or sub-acute care 0% - After deductible 40% - After deductible Speech Therapy Outpatient hospital/in a physician’s/therapist’s office. 0% - After deductible 40% - After deductible Surgery Services* Inpatient physician services 0% - After deductible 40% - After deductible Outpatient services - includes physician services and outpatient hospital or ambulatory surgical center facility services. 0% - After deductible 40% - After deductible In a physician’s office 0% - After deductible 40% - After deductible Telemedicine Services When rendered by our designated telemedicine provider. 0% - After deductible Not Covered When rendered by a network provider other than our designated telemedicine provider. See the covered healthcare service being provided for the amount you pay See the covered healthcare service being provided for the amount you pay Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Network Providers Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Tests, Labs, Imaging and X-rays - Diagnostic Outpatient, in a physician’s office, urgent care center or free-standing laboratory: Major diagnostic imaging and testing* including but not limited to: MRI, MRA, CAT scans, CTA scans, PET scans, nuclear medicine and cardiac imaging. 0% - After deductible 40% - After deductible Sleep studies.* 0% - After deductible 40% - After deductible Diagnostic imaging and tests, other than major diagnostic imaging and testing services noted above. 0% - After deductible 40% - After deductible Lab and pathology services. 0% - After deductible 40% - After deductible Diagnostic colorectal services - (Including, but not limited to, fecal occult blood testing, flexible sigmoidoscopy, colonoscopy, and barium enema. See Prevention and Early Detection Services for preventive colorectal services.) 0% - After deductible 40% - After deductible Lyme disease diagnosis and treatment 0% - After deductible 40% - After deductible
Radiation Therapy/Chemotherapy Services. Medically necessary high dose chemotherapy and radiation services related to autologous bone marrow transplantation is limited. See definition of Experimental/Investigational - Section 8.0. Inpatient Radiation therapy and chemotherapy services are covered as a hospital service. See Section
Radiation Therapy/Chemotherapy Services. Outpatient 0% - After deductible 40% - After deductible In a physician’s office 0% - After deductible 40% - After deductible Respiratory Therapy Inpatient 0% - After deductible 40% - After deductible Outpatient 0% - After deductible 40% - After deductible Skilled Care in a Nursing Facility* Skilled or sub-acute care 0% - After deductible 40% - After deductible Speech Therapy Outpatient hospital/in a physician’s/therapist’s office. 0% - After deductible 40% - After deductible Surgery Services* Inpatient physician services 0% - After deductible 40% - After deductible Outpatient services - includes physician services and outpatient hospital or ambulatory surgical center facility services. 0% - After deductible 40% - After deductible In a physician’s office 0% - After deductible 40% - After deductible Telemedicine Services When rendered by a designated provider. 0% - After deductible Not Covered When rendered by a network provider. 0% - After deductible Not Covered
Radiation Therapy/Chemotherapy Services. Outpatient 0% - After Deductible 20% - After Deductible In a doctor’s office 0% - After Deductible 20% - After Deductible Respiratory Therapy Inpatient 0% - After Deductible 20% - After Deductible Outpatient 0% - After Deductible 20% - After Deductible Skilled Nursing Facility Care Skilled or sub-acute care* 0% - After Deductible 20% - After Deductible
Radiation Therapy/Chemotherapy Services. Outpatient 10% - After deductible Not Covered In a physician’s office 10% - After deductible Not Covered Respiratory Therapy Inpatient 10% - After deductible Not Covered Outpatient 10% - After deductible Not Covered Skilled Care in a Nursing Facility* Skilled or sub-acute care 10% - After deductible Not Covered Speech Therapy Outpatient hospital/in a physician’s/therapist’s office. 10% - After deductible Not Covered Surgery Services Inpatient physician services 10% - After deductible Not Covered Outpatient physician services 10% - After deductible Not Covered In a physician’s office $30 Not Covered Telemedicine Services When rendered by a designated provider. $40 Not Covered When rendered by a network provider. $40 Not Covered Tests, Labs, Imaging and X-rays - Diagnostic Outpatient, in a physician’s office, urgent care center or free-standing laboratory: MRI*, MRA*, CAT scans*, CTA scans*, PET scans*, and nuclear medicine*. 10% - After deductible Not Covered Sleep studies.* 10% - After deductible Not Covered Diagnostic imaging and tests, other than the diagnostic imaging services listed above. 10% - After deductible Not Covered Lab and pathology services. 10% - After deductible Not Covered Diagnostic colorectal services - (Including, but not limited to, fecal occult blood testing, flexible sigmoidoscopy, colonoscopy, and barium enema. See Prevention and Early Detection Services for preventive colorectal services.) 10% - After deductible Not Covered Lyme disease diagnosis and treatment 10% - After deductible Not Covered Urgent Care Urgent care services $75 The level of coverage is the same as network provider. Vision Care Services Vision exam - one routine eye exam per member per plan year. $70 Not Covered Non-routine eye exam $60 Not Covered Covered Benefits - See Covered Healthcare Services for additional benefit limits and details. Care Coordinated by Your Primary Care Provider and Permitted Self-referrals Non-network Providers (*) Preauthorization may be required for this service. Please see Preauthorization in Section 5 for more information. You Pay You Pay Pediatric vision care Services - for members under age 19: See Vision Care Services in Section 3 for benefit limits and details. These services only apply to an enrolled member under the age of 19: Prescription glasses - frame and lenses 10% - After deductible Not Covered Contact lens (in lieu of prescription glasses) 10% - After deductible Not Covered Vision hardware for enrolled members aged 19 an...
Radiation Therapy/Chemotherapy Services. Outpatient 0% - After deductible 20% - After deductible In a physician’s office 0% - After deductible 20% - After deductible Respiratory Therapy Inpatient 0% - After deductible 20% - After deductible Outpatient 0% - After deductible 20% - After deductible Skilled Care in a Nursing Facility* Skilled or sub-acute care 0% - After deductible 20% - After deductible Speech Therapy Outpatient hospital/in a physician’s/therapist’s office. 20% - After deductible 40% - After deductible
Radiation Therapy/Chemotherapy Services. Outpatient 0% - After deductible Not Covered In a physician’s office 0% - After deductible Not Covered Respiratory Therapy Inpatient 0% - After deductible Not Covered Outpatient 0% - After deductible Not Covered Skilled Care in a Nursing Facility* Skilled or sub-acute care 0% - After deductible Not Covered Speech Therapy Outpatient hospital/in a physician’s/therapist’s office. 0% - After deductible Not Covered Surgery Services Inpatient physician services 0% - After deductible Not Covered Outpatient services - includes physician services and outpatient hospital or ambulatory surgical center facility services. 0% - After deductible Not Covered In a physician’s office 0% - After deductible Not Covered Telemedicine Services When rendered by our designated telemedicine provider. 0% - After deductible Not Covered When rendered by a network provider or non-network provider other than our designated telemedicine provider. See the covered healthcare service being provided for the amount you pay Not Covered