Urgently Needed Care
Urgently needed care is care for a sudden illness or injury that requires prompt attention but is not life-threatening. When a Medicare Advantage enrollee is outside the plan's service area and needs urgent care, the plan must cover it.
Definition
Urgently needed care is care for a sudden illness or injury that requires prompt attention but is not life-threatening. When a Medicare Advantage enrollee is outside the plan's service area and needs urgent care, the plan must cover it.
Why it matters
Coverage of out-of-area urgent care protects traveling patients and affects how such visits are authorized and billed.
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