2025 Blue Cross and Blue Shield Service Benefit Plan - Standard and Basic Option
Section 3. How You Get Care
You need prior Plan approval for certain services:
Emergency inpatient admission
Section 3. How You Get Care
You need prior Plan approval for certain services:
Emergency inpatient admission
• Emergency inpatient admission
If you have an emergency admission due to a condition that you reasonably believe puts your life in danger or could cause serious damage to bodily function, you, your representative, the physician, or the hospital must phone us within two business days following the day of the emergency admission, even if you have been discharged from the hospital. If you do not phone us within two business days, a $500 penalty may apply – see Warning under Inpatient hospital admissions earlier in this Section and If your facility stay needs to be extended below.
Admissions to residential treatment centers do not qualify as emergencies.
If you have an emergency admission due to a condition that you reasonably believe puts your life in danger or could cause serious damage to bodily function, you, your representative, the physician, or the hospital must phone us within two business days following the day of the emergency admission, even if you have been discharged from the hospital. If you do not phone us within two business days, a $500 penalty may apply – see Warning under Inpatient hospital admissions earlier in this Section and If your facility stay needs to be extended below.
Admissions to residential treatment centers do not qualify as emergencies.