Common use of Urgent Care Clause in Contracts

Urgent Care. We cover medically necessary visits to an urgent care center. Please note: Retail based clinics located in retail stores, supermarkets and pharmacies are not considered urgent care centers. Retail based clinics provide vaccinations and treat uncomplicated minor illnesses such colds, ear infections, minor wounds or abrasions. They are usually staffed by nurse practitioners or physician assistants and usually do not have a physician on site. For retail based clinic benefits, see Summary of Medical Benefits – Office Visits. When services, other than the physician/practitioner exam, are rendered in an urgent care center, the amount that you pay for non-exam services is based on the type of service being rendered (such as surgery, durable medical equipment, or machine tests). For surgery services (including, but not limited to sutures/stiches, fracture care, and other surgical procedures), see Section 3.35 - Surgery Services. For diagnostic imaging, lab and machine tests see Section 3.37. For durable medical equipment and supplies, see Section 3.9 - Durable Medical Equipment, Medical Supplies, Enteral Formula or Food, & Prosthetic Devices. See the Summary of Medical Benefits for benefit limits and the amount that you pay for each type of service. Follow-up care (such as suture removal or wound care) should be obtained from your primary care physician or specialist.

Urgent Care. We cover medically necessary visits to an urgent care center. Please note: Retail based clinics located in retail stores, supermarkets and pharmacies are not considered urgent care centers. Retail based clinics provide vaccinations and treat uncomplicated minor illnesses such colds, ear infections, minor wounds or abrasions. They are usually staffed by nurse practitioners or physician assistants and usually do not have a physician on site. For retail based clinic benefits, see Summary of Medical Benefits – Office Visits. When services, other than the physician/practitioner exam, are rendered in an urgent care center, the amount that you pay for non-exam services is based on the type of service being rendered (such as surgery, durable medical equipment, or machine tests). For surgery services (including, but not limited to sutures/stiches, fracture care, and other surgical procedures), see Section 3.35 - Surgery Services. For diagnostic imaging, lab and machine tests see Section 3.373.36. For durable medical equipment and supplies, see Section 3.9 - Durable Medical Equipment, Medical Supplies, Enteral Formula or Food, & Prosthetic Devices. See the Summary of Medical Benefits for benefit limits and the amount that you pay for each type of service. Follow-up care (such as suture removal or wound care) should be obtained from your primary care physician or specialist.