“You do have a
benefit for emergency situations. The following
information is the details on this benefit.
“[There is a] $75.00 co-payment for worldwide coverage of emergency department services. Emergency
care refers to services that are:
“Furnished by a provider qualified to furnish
emergency services and needed to evaluate or stabilize an emergency medical
condition. A medical emergency is when you, or any other prudent layperson with
an average knowledge of health and medicine, believe that you have medical
symptoms that require immediate medical attention to prevent loss of life, loss
of a limb, or loss of function of a limb. The medical symptoms may be an
illness, injury, severe pain, or a medical condition that is quickly getting
worse.
“World Wide-Emergency Co-payments are waived if
admitted to the hospital within 24 hours for the same condition. If you are
admitted to a hospital, you will pay cost sharing as described in the Inpatient
Hospital Care section below.
“Transportation back to the United States from
another country is not covered. Pre-scheduled and/or elective procedures are not
covered. If you receive emergency care at an out-of-network hospital and need
inpatient care after your emergency condition is stabilized, you must move to a
network hospital in order to pay the in-network cost-sharing amount for the
part of your stay after you are stabilized.
“If you stay at the out-of-network hospital,
your stay will be covered but you will pay the out-of-network cost-sharing
amount for the part of your stay after you are stabilized. Co-payment/Coinsurance
does apply toward the Combined Annual Out-of-Pocket Maximum.
“Plans are insured through United Healthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract for Medicare Advantage Plans. Enrollment in the plan depends on the plan’s contract renewal with Medicare. United Healthcare Insurance Company pays royalty fees to AARP for the use of its intellectual property. These fees are used for the general purposes of AARP. AARP and its affiliates are not insurers.”
Glen, Thank you for this info
ReplyDeleteEarl