afiamirza
Jul 23, 2012, 09:54 AM
What sort of emergency situations are covered by out of network insurance?
smoothy
Jul 23, 2012, 10:19 AM
what sort of emergency situations are covered by out of network insurance?
Only what your policy states. There isn't a universal answer.
smearcase
Jul 23, 2012, 01:03 PM
Smoothie is exactly right.
However, I happen to have a booklet here that includes some of the typical language used by one of the many companies that can be selected as part of a menu of health plans.
This is just one example of many types of requirements that MIGHT be in a randomly selected plan:
"*** Emergency services or medical emergency is
defined as: health care services that are provided
in a hospital emergency facility after the sudden
onset of a medical condition that manifests itself
by symptoms of sufficient severity, including
severe pain, that the absence of immediate
medical attention could reasonably be expected
by a prudent layperson, who possesses an average
knowledge of health and medicine, to result in:
• Placing the patient’s health in jeopardy;
• Serious impairment of bodily functions; or
• Serious dysfunction of any bodily organ or
part. "
Just some general info and of course not likely to be the language used in the plan you might have or might be considering.