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Medical Event / Incident

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A Medical Event (or Medical Incident) are all medical bills incurred from the first doctors visit/test, to the last treatment/follow up visit before the doctor releases you to a regular, routine maintenance regimen. This is one single Medical Event (or Medical Incident).

 

A medical incident includes medical treatment or testing that lasts until one of the following events occurs:

1. A certain medical condition is cured according to official medical  records;

2.  Treatment is at a routine maintenance level; or

3. You experience 90 days without any kind of treatment for that particular condition.

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If 90 days pass and you receive no further treatment, any future bills you incur will be considered a separate incident.

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Personal responsibility amounts for the Silver and Bronze participation levels are per incident (Gold personal responsibility is per person, per year).

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A Medical Event / Medical Incident may include some or all of the following items (and more), in no particular order:

• Initial doctors visit (could be routine)

• Testing, like CT scan, X-ray or MRI

• Lab work

• Procedures

• Follow up visit

• Referral to see a specialist

• Surgery

• Anesthesia

• Urgent Care

• ER room

• Out patient services

• Maternity 

• Physical Therapy

• Home Healthcare

• Etc

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Example: You go to the doctor due to pain in your side. He examines you and gives you some instructions before sending you home. The next week you return because the pain has continued. The doctor orders a blood test and an ultrasound. After reviewing the results, he diagnoses you with appendicitis and sends you to the hospital. He performs an appendectomy.

 

The hospital releases you with instructions to visit the doctor’s office in one week for follow-up. At that visit the doctor tells you come back again the following week, at which time he pronounces you cured.

 

All the medical bills you incurred for each of these situations fall under the category of a single incident.

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Your total cost will be your personal responsibility

(Gold: $1,000   Silver $2,500   Bronze $5,000).

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See examples here