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    afiamirza's Avatar
    afiamirza Posts: 1, Reputation: 1
    New Member
     
    #1

    Jul 23, 2012, 09:54 AM
    Out of network insurance
    What sort of emergency situations are covered by out of network insurance?
    smoothy's Avatar
    smoothy Posts: 25,492, Reputation: 2853
    Uber Member
     
    #2

    Jul 23, 2012, 10:19 AM
    Quote Originally Posted by afiamirza View Post
    what sort of emergency situations are covered by out of network insurance?
    Only what your policy states. There isn't a universal answer.
    smearcase's Avatar
    smearcase Posts: 2,392, Reputation: 316
    Ultra Member
     
    #3

    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.

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