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<br />c. <br /> <br />D. <br /> <br />E. <br /> <br />SB-A2 <br /> <br />Em.rg.ncy H.alth S.rvic.. R.nd.r.d By Hon-Participating Provid.r. <br /> <br />1. <br /> <br />Health Plan will cover Eligible Expenses for Medically Necessary <br />Emergency Health Services rendered by non-participating providers <br />to a Covered Person, subJect to the terms and conditions of this <br />section. <br /> <br />..., <br />.,;.. <br /> <br />The required Emergency Health Services and follow-up care if <br />applicable must be (1) of such immediate nature that the Covered <br />Person's health might be Jeopardized if taken to a treatment <br />location where the services of a Participating Provider would be <br />available, or (2) provided under circumstances under which the <br />Covered Person is unable, due to his or her condition, to request <br />treatment at a location where the services of a Participating <br />Provider would be available. <br /> <br />3. <br /> <br />The Covered Person must notify Health Plan within 48 hours after <br />Emergency Health Services are initially provided by a non- <br />participating provider, or as soon thereafter as is reasonably <br />possible. Full details of the initial and continuing Emergency <br />Health Services shall be made available at the request of Health <br />Plan. <br /> <br />4. <br /> <br />If the Covered Person is hospitalized, the Covered Person may be <br />transferred to a Participating Hospital, upon request by a <br />Participating Physician, as soon as it is medically appropriate <br />in the opinion of the attending Physician. <br /> <br />~. <br /> <br />Medically Necessary transportation by a reasonable mode for <br />transfer from a Hospital where the Covered Person was confined <br />for Emergency Health Services to another Hospital to facilitate <br />continued care and attendance by a Participating Physician is <br />covered if authorized in writing in advance by Health Plan. <br /> <br />6. <br /> <br />Copayments apply as indicated in the Contract, riders, amendments <br />and addenda. <br /> <br />Eligible Exp.n... for Em.rg.ncy H.alth S.rvic.. <br /> <br />Eligible Expenses for Emergency Health Services are the charges for <br />the Medically Necessary Health Services provided during the course of <br />the Emergency. The Health Services must be provided by or under the <br />direction of a physician and are subJect to the exclusions and other <br />provisions of this Contract. <br /> <br />Benefits <br /> <br />Health Plan will provide the following Medically Necessary Health <br />Services, subJect to the terms and conditions as stated in A above and <br />in the Group Master Contract/Enrollees Certificate of Coverage: <br /> <br />CopaYIII.nt Charg. <br /> <br />1. <br /> <br />Medical Services (except for the Medical <br />Services identified in this section under <br /> <br />-2- <br />