What sort of emergency situations are covered by out of network insurance?

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Originally Posted by afiamirza

what sort of emergency situations are covered by out of network insurance?

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Only what your policy states. There isn't a universal answer.

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.