Emergencies
[All information is subject to change without notice.]
When a medical emergency occurs, seek emergency care at the nearest hospital or emergency facility. If you need ambulance transportation, you may dial 911 from most regular and cellular phone lines.
The Student Health Insurance Plan considers an emergency to be the sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in: 1) placement of the insured's health in serious jeopardy; 2) serious impairment of bodily functions; or 3) serious dysfunction of any body organ or part; 4) Serious disfigurement; 5) In the case of a pregnant woman, serious jeopardy to the health of the fetus.
If hospital confinement should result from a covered medical emergency, benefits will be paid at 80% of the preferred allowance for covered medical expenses in a preferred provider hospital.
If confined in an out-of-network hospital, benefits will be paid at 80% of allowable charges until it is medically possible to be transferred to a preferred provider hospital. If the transfer is not made when medically possible, the benefit will revert to out-of-network non-emergency allowance. At that time, benefits will be paid at 60% of allowable charges for covered medical expenses incurred.
See Also
Updated: October 25, 2007