Page 52 - EPO_Member_Kit

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I S i t A N E M E R G E N C Y O R I S I T U R G E N T ?
Wherever your travels take you, you have worldwide
coverage for emergencies. Emergency care is care
necessary to screen and stabilize an enrollee in cases
where a person with no medical training, acting
reasonably, believes that an emergency medical
condition exists. Emergency care is available on an
immediate basis, 24 hours a day, seven days a week.
If you need emergency care, go to the nearest
emergency room or call 911 for assistance. We cover
emergency treatment at any emergency room when
you are unable to reach a Alliance-affiliated facility.
If you receive emergency care out of the state or out of
the country, the hospital may not recognize your
Alliance ID card and require immediate payment for
services. If this happens, don’t worry. We will fully
reimburse you for any emergency services less any
cost-sharing amounts. Please send an itemized bill and
a copy of your receipt to:
Alliance Health and Life Insurance Company
ATTN: Enrollee Reimbursement
2850 W. Grand Boulevard
Detroit, MI 48202
Also note that if you have a deductible, costs may go
to the deductible before Alliance makes payment for
services. Please check your Group Health Insurance
Policy for details.
Emergency Admissions
If you have a medical emergency and are admitted
to a hospital that is not affiliated with us, we must
be notified within 48 hours. The telephone number,
(313) 664-7010
or toll-free
(888) 999-4347
, is on the
back of your ID card. Failure to notify Alliance could
result in the denial of payment for the services
you receive.
We will contact the doctor treating you to evaluate
your medical condition and the doctor’s treatment
plan. When it is safe to do so, you may be transferred
to an Alliance-affiliated hospital. The cost of a transfer
is a covered service if the transfer is authorized and
arranged by us. If you refuse to transfer, your
continued care at the non-affiliated facility will not
be covered by us. You will be financially responsible for
all care received after you refuse a transfer.
Follow-up Care
It is important to contact your doctor’s office for care
after receiving emergency treatment if you wish to
incur the least out-of-pocket expense. All follow-up
care must be provided by your Alliance-affiliated doctor
in order for you to receive coverage.