Emergency Room Care
With the PPO plans, when you need emergency care and use an emergency room, you pay a $150 copayment and the Plan pays the balance of emergency room charges; no deductible applies. The emergency room copayment is waived if you are admitted to the hospital as an inpatient through the emergency room.
With the HSA medical plans, emergency room care is subject to the deductible and coinsurance.
These benefits apply only when you use a hospital emergency room for a true medical emergency. A "true medical emergency" is defined as a serious medical condition or symptom resulting from injury, sickness or mental illness, which arises suddenly and, in the judgment of a reasonable person, requires immediate care and treatment, generally within 24 hours of onset, to avoid jeopardy to life or health.