• receiving treatment for Mental Health and Substance Use Disorder Services in a Mental Health or Substance Use Disorder Residential Treatment Center.
Hospice Facility The term Hospice Facility means an institution or part of it which: • primarily provides care for Terminally Ill patients; • is accredited by the National Hospice Organization; • meets standards established by Cigna; and • fulfills any licensing requirements of the state or locality in which it operates.
HC-DFS807
12-15
Injury The term Injury means an accidental bodily injury.
HC-DFS12
04-10 V1
HC-DFS53
04-10 V1
Maintenance Drug Product A Prescription Drug Product that is prescribed for use over an extended period of time for the treatment of chronic or long- term conditions such as asthma, hypertension, diabetes and heart disease, and is identified principally based on consideration of available data resources, including, but not limited to, First DataBank or another nationally recognized drug indicator source and clinical factors. For the purposes of benefits, the list of your plan’s Maintenance Drug Products does not include compounded medications, Specialty Prescription Drug Products or Prescription Drug Products, such as certain narcotics that a Pharmacy cannot dispense above certain supply limits per Prescription Drug Order or Refill under applicable federal or state law. You may determine whether a drug is a Maintenance Medication by calling member services at the telephone number on your ID card.
Hospital The term Hospital means: • an institution licensed as a hospital, which: maintains, on the premises, all facilities necessary for medical and surgical treatment; provides such treatment on an inpatient basis, for compensation, under the supervision of Physicians; and provides 24-hour service by Registered Graduate Nurses; • an institution which qualifies as a hospital, a psychiatric hospital or a tuberculosis hospital, and a provider of services under Medicare, if such institution is accredited as a hospital by the Joint Commission on the Accreditation of Healthcare Organizations; or • an institution which: specializes in treatment of Mental Health and Substance Use Disorder or other related illness; provides residential treatment programs; and is licensed in accordance with the laws of the appropriate legally authorized agency. The term Hospital does not include an institution which is primarily a place for rest, a place for the aged, or a nursing home.
HC-DFS847
10-16
Maintenance Treatment The term Maintenance Treatment means: • treatment rendered to keep or maintain the patient's current status.
HC-DFS1485
01-21
HC-DFS56
04-10 V1
Hospital Confinement or Confined in a Hospital A person will be considered Confined in a Hospital if he is: • a registered bed patient in a Hospital upon the recommendation of a Physician;
Maximum Reimbursable Charge – Medical See The Medical Schedule for information about Out-of- Network Charges for Certain Services, Out-of-Network Emergency Services Charges, and Out-of-Network Air Ambulance Services Charges.
myCigna.com
80
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