Respite care means care anticipated to be provided in a nursing home for a period of 28 days or less for the purpose of temporarily relieving a family member or other caregiver from his or her daily caregiving duties.
Hospice Care means a coordinated program of active professional
Acute care means preventive care, primary care, and other medical care provided under the direction of a physician for a condition having a relatively short duration.
Palliative care means medical ser- vice rendered to reduce or moderate tempo- rarily the intensity of an otherwise stable medical condition, but does not include those medical services rendered to diagnose, heal or permanently alleviate or eliminate a med- ical condition.
Child care means continuous care and supervision of five or more qualifying children that is:
Routine care means medical care which is not urgent or emergent in nature and can wait for a regularly scheduled physician appointment without risk of permanent damage to the patient’s life or health status. The condition requiring routine care is not likely to substantially worsen without immediate clinical intervention.
Pharmacy care means medications prescribed by a licensed physician and related services performed by a licensed pharmacist and any health-related services considered medically necessary to determine the need or effectiveness of the medications.
Preventive Care means certain Preventive Care services.
Urgent Care means medical care or treatment where application of the time periods for making non-urgent care decisions could 1) seriously jeopardize the insured’s life, health or ability to regain maximum function or 2) in the opinion of a physician with knowledge of the insured’s medical condition, would subject the insured to severe pain that cannot be adequately managed without the care or treatment. The determination of whether care is Urgent Care is to be made by an individual acting on behalf of the Plan applying the judgment of a prudent layperson who possesses an average knowledge of health and medicine. The determination can also be made by a physician with knowledge of the insured’s medical condition.
Maritime cargo handling services means activities exercised by stevedore companies, including terminal operators, but not including the direct activities of dockers, when this workforce is organised independently of the stevedoring or terminal operator companies. The activities covered include the organisation and supervision of:
Adult foster care means room and board, supervision, and special services to an adult who has a
Emergency care means management for an illness or injury which results in symptoms which occur suddenly and unexpectedly, and requires immediate care by a medical practitioner to prevent death or serious long term impairment of the insured person’s health.
Home care services means skilled or personal care services provided to clients in their place of residence for a fee;
Day Care means the care, assistance, and supervision of an individual who does not stay overnight. Individuals receiving day care services are included in the licensed capacity of a home as described in OAR 411-360-0060.
Respiratory care means the practice of the allied health profession responsible for the direct and
Medical care means amounts paid for:
In Patient Care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.
Foster care means substitute care furnished on a 24-hour-a-day basis to an eligible child, in a licensed foster care facility or approved shelter care facility, by a person or agency other than the child’s parent or guardian, but does not include care provided in a family home through an informal arrangement for a period of less than 30 days. Child foster care shall include but is not limited to the provision of food, lodging, training, education, supervision, and health care.
Emergency medical care means such medical procedures as:
PREVENTIVE CARE SERVICES means covered healthcare services performed to prevent the occurrence of disease as defined by the Affordable Care Act (ACA). See Preventive Care and Early Detection Services in Section 3. PRIMARY CARE PROVIDER (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.
Home health aide services means the personal care and maintenance activities provided to individuals for the purpose of promoting normal standards of health and hygiene.
Centers for Medicare and Medicaid Services or “CMS” means the federal office under the Secretary of the United States Department of Health and Human Services, responsible for the Medicare and Medicaid programs.
Primary care means routine health care services, including
Inpatient care means treatment for which the insured person has to stay in a hospital for more than 24 hours for a covered event.
Home Health Care means the continual care and treatment of an individual if:
Substitute care means the out-of-home placement of a child or young adult who is in the legal or physical custody and care of the Department.