Inpatient and Outpatient Benefit Services

Hospital Team

Enhanced benefits in addition to base benefits:

As you know Plan Provisions are the rules or conditions regarding what can be done in a plan.

Enhanced benefits in addition to base benefits:

  • Inpatient Psych/Substance Abuse benefits limited to 30 days per year
  • Additional Inpatient Annual Maximum benefit is limited to stated annual maximum
  • Inpatient Only Hospitalization and Professional Services for Surgical and Medical Services plus
  • Outpatient Surgical (only) Services

Benefit provision is effective
90 days after member effective date.

The following benefits are ONLY available if the patient ends up being admitted:

  • Emergency Room/Urgent Care, Lab, X-ray and Imaging
  • Ambulance Service
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