Eligible Emergency Room visits defined as Medical Emergency apply towards deductible then covered at 80% for in network and 80% or Reasonable and Customary out-of-network if admitted inpatient.
Medical Emergency means the occurrence of a sudden, serious and unexpected Sickness or Injury. In the absence for immediate medical attention, a reasonable person could believe the condition would result in:
- Placement of the Insured's health in jeopardy;
- Serious impairment of bodily functions;
- Serious dysfunction of any body organ or part; or
- In the case of a pregnant woman, serious jeopardy to the health of the fetus.
Urgent Care (for the remainder of Plan 13-14 effective until 8/31/14)
Eligible Urgent Care Clinic charges will be covered the same as outpatient emergency care according to the networks used.
To find an Urgent Care clinic in Colorado please visit www.cofinity.net outside Colorado www.firsthealth.com.
How to find network providers for the new plan year 14-15 effective 8/1/14 for new students to the plan and 9/1/14 for returning students to the plan.
Insured Students have access Care Management, designed to help manage the care of patients who have a catastrophic or extended care Accident or Sickness. Please contact 1-800-767-0700.
The master policy on file at the university contains all the provisions, limitations, exclusions, and qualifications of the plans, which may not be included on the web pages. The master policy is the contract and will govern and control the payment of benefits.
The information on this website is intended to provide guidance to the benefits of the insurance and how to utilize its services. It in no way constitutes a guarantee of payment for claims submitted to the insurance company.