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Medicare: Definition Of Emergency

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"Emergency" is defined for purposes of Medicare+ Choice policies as:

A medical condition manifesting itself by acute symptoms of sufficient severity (including severe pain) such that a prudent layperson, who possesses an average knowledge of health and medicine, could reasonably expect the absence of immediate medical attention to result in:

  • Placing the health of the individual (or, in the case of a pregnant woman, the health of the woman or her unborn child) in serious jeopardy; or
  • Serious impairment to bodily functions; or,
  • Serious dysfunction to a bodily organ or part.

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