Saturday, April 22, 2017

Traveling out of the country with your United Healthcare Group Medicare Advantage (PPO)?

“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.

“You pay these amounts until you reach the Out-of-Pocket maximum. This service does not apply toward the Annual Individual Deductible. The deductible does not need to be met before any Co-payment/Coinsurance would apply towards this service.

“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.”

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