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What Do You Mean It's Not Covered: Optional Coverage: Intensive Care Expense

HOSPITAL INTENSIVE CARE UNIT COVERAGE -- The benefit we will pay when confined in an intensive care unit of a hospital will be the expense, up to the daily amount shown on page EI2,5 for the insured person. The benefit (1) will not be paid for more than 14 days during one period of hospital confinement (2) will not exceed the expense incurred, and (3) will be in lieu of the amount that would otherwise be paid for the hospital room. An intensive care unit means that part of a hospital which (1) is permanently equipped and staffed (2) provides more extensive care for the critically ill or injured patients than is available in other hospital rooms or wards (3) has trained and qualified personnel, including at least one graduate registered nurse in continuous attendance 24 hours a day, for the care and close observation of the confined patients and for which an additional hospital charge is made. In order for benefits to be paid under this coverage, the hospital confinement: (1) must be for an injury or sickness (2) must begin while this coverage is in force for the person confined (3) must be at the direction of and under the supervision of a physician or surgeon.

This is an optional coverage for intensive care that only applies to each insured for whom it is shown in the policy schedule. The benefit is limited to 14 days during any one period of confinement, to the actual expenses charged, and to the daily amount shown in the schedule. This benefit is paid instead of the inpatient benefit for hospital room charges. Since intensive care is usually more expensive than regular care, an insured may have $300 per day of coverage for room and board and $500 per day of coverage for intensive care. An "intensive care unit" means a part of a hospital which is designed for providing more extensive care to critically ill or injured patients, is permanently equipped and staffed, has at least one graduate registered nurse in attendance 24 hours a day, and for which an additional hospital charge is made. Benefits for intensive care are payable only when the hospital confinement is for treatment of injury or sickness, begins while coverage is in force, and is at the direction of a physician or surgeon.

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