Emergency Room Services - (A005)

Emergency room services for emergency medical conditions — including physical/mental evaluation and stabilization — are covered (including non‑participating providers billed at in‑network cost‑share) and do not require prior authorization or referral. Coverage is subject to the applicable benefit plan terms, state regulations, and case-specific facts, and the listed emergent conditions are examples, not exhaustive.

"Emergency room services provided for treatment of an emergency medical condition."

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