A qualifying hospital admission means an unscheduled admission to an accredited facility* such as a Hospital, ER, or Surgical Center that: (1) results from a Covered Procedure; (2) is Medically Necessary; (3) is based on an approved Admitting Diagnosis; and (4) occurs within the 30 day period which begins immediately following the administration of either general anesthesia, or intravenous sedation in preparation of a Covered Procedure(s). Benefit amounts vary upon the length of treatment.
Qualifying Admitting Diagnosis
Cardiopulmonary Related Complications:
- Myocardial infarction
- Rule out myocardial infarction
- Arrhythmia
- Hypoxia
- Pulmonary dysfunction
- Pulmonary embolus
- Rule out pulmonary embolus
- Fluid overload
- Cardiac Arrest
- Shock
- Deep Vein Thrombosis
- Rule Out Deep Vein Thrombosis
Surgery Related Complication:
- Hemorrhage
- Infection**
Anesthesia Related Complications:
- Severe hypotension (systolic BP equal to or less than 80, three hours after the covered procedure).
- Severe hypertension (systolic BP equal to or greater than 200 or diastolic BP equal to or greater than 100, three hours after the Covered Procedure).
*Accreditation requirements include JCAHO, AAAHC, AAAASF or Medicare approval.
**Infections that are related to the Covered Procedure.
