Common use of Transition of Care Benefits Clause in Contracts

Transition of Care Benefits. If you are a new HMO enrollee and you are receiving care for a condition that requires an Ongoing Course of Treatment or if you have entered into the second or third trimester of pregnancy, and your Physician does not belong to the Plan's network, but is within the Plan's service area, you may request the option of xxxx­ sition of care benefits. You must submit a written request to the Plan for transition of care benefits within 15 business days of your eligibility effective date. If you are a current HMO enrollee and you are receiving care for a condition that requires an Ongoing Course of Treatment or if you have entered into the second or third trimester of pregnancy and your Primary Care Physician or Woman's Principal Health Care Provider leaves the Plan's network, you may request the option of transition of care benefits. You must submit a written request to the Plan for transition of care benefits within 30 business days after receiving notification of your Primary Care Physician or Woman's Principal Health Care Provider's ter­ mination. The Plan may authorize transition of care benefits for a period up to 90 days. Au­ thorization of benefits is dependent on the Physician's agreement to contractual requirements and submission of a detailed treatment plan. A written notice of the Plan's determination will be sent to you within 15 business days of receipt of your request. GB‐16 HCSC 28

Transition of Care Benefits. If you are a new HMO enrollee and you are receiving care for a condition that requires an Ongoing Course of Treatment or if you have entered into the second or third trimester of pregnancy, and your Physician does not belong to the Plan's network, but is within the Plan's service area, you may request the option of xxxx­ sition of care benefits. You must submit a written request to the Plan for transition of care benefits within 15 business days of your eligibility effective date. If you are a current HMO enrollee and you are receiving care for a condition that requires an Ongoing Course of Treatment or if you have entered into the second or third trimester of pregnancy and your Primary Care Physician or Woman's Principal Health Care Provider leaves the Plan's network, you may request the option of transition of care benefits. You must submit a written request to the Plan for transition of care benefits within 30 business days after receiving notification of your Primary Care Physician or Woman's Principal Health Care Provider's ter­ mination. IL‐G‐H‐OF‐2016 32 The Plan may authorize transition of care benefits for a period up to 90 days. Au­ thorization of benefits is dependent on the Physician's agreement to contractual requirements and submission of a detailed treatment plan. A written notice of the Plan's determination will be sent to you within 15 business days of receipt of your request. GB‐16 HCSC 28IL‐G‐H‐OF‐2016 33

Transition of Care Benefits. If you are a new HMO enrollee and you are receiving care for a condition that requires an Ongoing Course of Treatment or if you have entered into the second or third trimester of pregnancy, and your Physician does not belong to the Plan's network, but is within the Plan's service area, you may request the option of xxxx­ sition of care benefits. You must submit a written request to the Plan for transition of care benefits within 15 business days of your eligibility effective date. If you are a current HMO enrollee and you are receiving care for a condition that requires an Ongoing Course of Treatment or if you have entered into the second or third trimester of pregnancy and your Primary Care Physician or Woman's Principal Health Care Provider leaves the Plan's network, you may request the option of transition of care benefits. You must submit a written request to the Plan for transition of care benefits within 30 business days after receiving notification of your Primary Care Physician or Woman's Principal Health Care Provider's ter­ mination. The Plan may authorize transition of care benefits for a period up to 90 days. Au­ thorization of benefits is dependent on the Physician's agreement to contractual requirements and submission of a detailed treatment plan. A written notice of the Plan's determination will be sent to you within 15 business days of receipt of your request. GB‐16 HCSC 2829