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6.1.4 Participating Providers |
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Individuals covered under the Value Plan who reside in the HealthLink service area, must use HealthLink (or USA) PPO providers. Except as described below, no non-PPO provider coverage will be provided for those Participants. Participants who reside outside the HealthLink service area may use USA MCO providers; if they do not, non-PPO providers will be covered subject to Usual, Customary and Reasonable benefit limitations as defined in Section 4.3.1, which begins on page 67.
The Value Plan also covers the following non-PPO services as if they were PPO providers:
(a) non-network ambulance, radiologists, pathologists and anesthesiologists if the patient is admitted to an PPO Hospital by an PPO Physician;
(b) non-network ambulance and Physicians if the patient receives Emergency care at a PPO Hospital emergency room; and
(c) Emergency care while traveling. |
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TABLE OF CONTENTS |
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St. Louis Graphic Arts Joint Health & Welfare Fund
14323 South Outer Forty Rd. - Suite S106
Chesterfield, Missouri 63017 |
Fund Office: (314) 878-1579
twesthues@slgahw.org
Fax: (314) 275-2640 |
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If you have any comments about this web site, please contact us at twesthues@slgahw.org. |
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