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<s>[INST] For the Healthy Life EasyShare Programs, What types of medical expenses are eligible for immediate sharing in the Healthy Life EasyShare Programs, and are there any exceptions to the waiting periods? [/INST] Assistant : Certain medical expenses, such as Primary Care, Specialty Care, Pediatric, and Urgent Care office visits, are eligible for immediate sharing and are not subject to the waiting periods. However, other services like Imaging have specific waiting periods. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Could you explain how the Consultation Fees work in the Healthy Life EasyShare Programs and whether they apply to all medical visits? [/INST] Assistant : Consultation Fees in the EasyShare Programs are fees that members must pay at the time of their medical visit. These fees apply to various types of medical visits, including Telemedicine, Primary Care, Pediatric, and Preventive Care. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What are the criteria for sharing eligibility for Emergency Room and Ambulance services in the Healthy Life EasyShare Programs? [/INST] Assistant : Emergency Room and Ambulance services in the EasyShare Programs are eligible for sharing if they are related to life-threatening or severely health-jeopardizing conditions that result in an in-patient hospital stay. Specific sharing limits apply. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, can members receive sharing for medical imaging services performed at a hospital, or must they be obtained at a freestanding, in-network diagnostic center? [/INST] Assistant : Medical imaging services in the EasyShare Programs can be obtained at a hospital if received as an admitted patient. However, for outpatient services, they should be procured at a freestanding, in-network diagnostic center to be eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Are there any restrictions on the number of visits or days eligible for sharing for Routine Annual Physical or Well Child Exams in the Healthy Life EasyShare Programs? [/INST] Assistant : Yes, there are restrictions on the number of visits eligible for sharing for Routine Annual Physical or Well Child Exams in the EasyShare Programs. Only one visit per Program Year is eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum sharing amount for room and board expenses during inpatient hospitalization in the Healthy Life EasyShare Programs? [/INST] Assistant : The maximum sharing amount for room and board expenses during inpatient hospitalization in the EasyShare Programs varies depending on the program option. For EasyShare50, it's up to $3,000 per day, and for EasyShare25, it's up to $2,500 per day. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain the Per-Surgical Procedure Limit for inpatient and outpatient surgery in the Healthy Life EasyShare Programs, and how many procedures are eligible for sharing per Program Year? [/INST] Assistant : The Per-Surgical Procedure Limit specifies the maximum sharing amount for surgical procedures in the EasyShare Programs. Members are eligible for up to two surgical procedures per Program Year, each with its own sharing limit. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Annual Combined Program Maximum for the Healthy Life EasyShare Programs, and how does it affect sharing limits for members? [/INST] Assistant : The Annual Combined Program Maximum sets the maximum amount of medical expenses that may be shared for any individual member in the EasyShare Programs. It varies depending on whether a member is in EasyShare50 or EasyShare25. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, what is the purpose of the Annual Non-Sharable Amount, and how does it differ between program options? [/INST] Assistant : The Annual Non-Sharable Amount is the portion of medical expenses that members must pay out of pocket before sharing begins. In the EasyShare Programs, there is no Annual Non-Sharable Amount; it's $0 for both EasyShare50 and EasyShare25. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain how the lifetime sharing limits work in the Healthy Life EasyShare Programs, and what are the maximum amounts for each program option? [/INST] Assistant : The lifetime sharing limits in the EasyShare Programs determine the maximum amount of sharing available to individual members over their lifetime. For EasyShare50, it's $500,000, and for EasyShare25, it's $250,000. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the significance of the 180-day waiting period for Cologuard testing in the Healthy Life EasyShare Programs? [/INST] Assistant : The 180-day waiting period for Cologuard testing ensures that members have been part of the program for an extended period before becoming eligible for sharing such expenses. It helps control costs and encourages continuous membership. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Could you provide more information about the Annual Routine Physical, Well Child Exam, and Preventive Care Combined Sharing Limit in the Healthy Life EasyShare Programs? [/INST] Assistant : Certainly, the Annual Routine Physical, Well Child Exam, and Preventive Care Combined Sharing Limit in the EasyShare Programs is set at a maximum of $500 per member per year for both EasyShare50 and EasyShare25. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, are there any specific requirements for medical expenses related to imaging, such as CT Scans, MRIs, and X-Rays, to be eligible for sharing? [/INST] Assistant : Yes, for outpatient CT Scan, MRI, and X-Ray imaging to be eligible for sharing in the EasyShare Programs, they must be obtained with a physician's prescription and procured at a freestanding, in-network diagnostic center unless received as an admitted patient. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you clarify the maximum number of incidents for Emergency Room and Ambulance services in the Healthy Life EasyShare Programs? [/INST] Assistant : Certainly, in the EasyShare Programs, both Emergency Room and Ambulance services are limited to a maximum of two incidents per year. These services are intended for life-threatening conditions that result in an in-patient hospital stay. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How does the program determine the Per-Medical-Incident Sharing Limits for inpatient hospitalization and surgery in the Healthy Life EasyShare Programs? [/INST] Assistant : The Per-Medical-Incident Sharing Limits for inpatient hospitalization and surgery in the EasyShare Programs are predetermined and set to control sharing amounts for specific types of medical events. These limits ensure that sharing is fair and sustainable. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Are there any sharing percentages applied to the medical expenses in the Healthy Life EasyShare Programs, or is sharing based on predefined limits? [/INST] Assistant : In the EasyShare Programs, there are no sharing percentages applied. Sharing is based on predefined limits, as specified for various types of medical needs and incidents. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum number of visits or days eligible for sharing for Urgent Care in the Healthy Life EasyShare Programs? [/INST] Assistant : For Urgent Care in the EasyShare Programs, members are eligible for sharing up to two visits per Program Year. This helps cover immediate healthcare needs without overextending sharing resources. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain how the Annual Visits & Hospitalization Sharing Limits impact members in the Healthy Life EasyShare Programs? [/INST] Assistant : The Annual Visits & Hospitalization Sharing Limits set a maximum number of visits or days eligible for sharing for various types of medical needs, ensuring that sharing remains within predefined limits per member per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the significance of the waiting periods mentioned in the Healthy Life EasyShare Programs, such as the 180-day waiting period for Cologuard testing? [/INST] Assistant : The waiting periods serve to ensure that members have continuous participation in the program before certain medical expenses become eligible for sharing. For instance, the 180-day waiting period for Cologuard testing helps maintain program sustainability and cost control. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Could you explain the Annual Sharing Limits for the Healthy Life EasyShare Programs? How do these limits affect sharing for members? [/INST] Assistant : The Annual Sharing Limits determine the maximum amount of medical expenses that can be shared for each member in a program year. For EasyShare50, the maximum is $50,000, and for EasyShare25, it's $25,000. These limits help manage the program's financial commitments and ensure fairness in sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, For the case of Emergency Room and Ambulance services, what criteria must be met for expenses to be eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : Emergency Room and Ambulance expenses are eligible for sharing when they are associated with medical conditions that are life-threatening or could seriously jeopardize the health of the individual and result in an in-patient hospital stay. This criteria ensures that sharing is reserved for critical situations. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Are there any restrictions on the types of medical incidents covered under the Per Medical Incident Sharing Limits in the Healthy Life EasyShare Programs? [/INST] Assistant : The Per Medical Incident Sharing Limits apply to various types of medical incidents, including inpatient hospitalization, surgery, emergency room visits, ambulance services, CT scans, MRIs, and X-rays. These limits help standardize sharing for different types of medical needs. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum annual per-member amount shared in the Healthy Life EasyShare Programs, and how does it differ between EasyShare50 and EasyShare25? [/INST] Assistant : The maximum annual per-member amount shared in the EasyShare Programs is $50,000 for EasyShare50 and $25,000 for EasyShare25. These limits apply to various medical incidents and help ensure financial sustainability. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain how the Consultation Fees work in the Healthy Life EasyShare Programs? What are they used for? [/INST] Assistant : Consultation Fees in the EasyShare Programs are per-visit fees that members must pay at the time of their visit. These fees are never eligible for sharing and are the member's personal responsibility. They cover the cost of consultation with healthcare professionals. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, For the context of the Healthy Life EasyShare Programs, what does it mean when it's mentioned that sharing is subject to annual program limits? [/INST] Assistant : When sharing is subject to annual program limits, it means that the total amount of sharing for an individual member throughout the program year cannot exceed the predefined limits, such as the Annual Sharing Limit or Per Medical Incident Sharing Limits. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Could you clarify the sharing eligibility for Preventive Services in the Healthy Life EasyShare Programs? Is there a waiting period for these services? [/INST] Assistant : Preventive Services, including an Annual Routine Physical or Well Child Exam, have a 30-day waiting period in the EasyShare Programs. Members must pay a Consultation Fee for each visit, and after that, the remaining portion of physician charges for the office visit is eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What types of medical expenses are considered 'life-threatening' or capable of seriously jeopardizing health, making them eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : In the EasyShare Programs, medical conditions that are life-threatening or could seriously jeopardize the health of the individual and result in an in-patient hospital stay are considered eligible for sharing. This includes expenses related to Emergency Room visits and Ambulance services. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Are there any limitations on the number of visits or days eligible for sharing for Primary Care, Specialty Care, Pediatric, and Urgent Care office visit charges in the Healthy Life EasyShare Programs? [/INST] Assistant : Yes, there are limits on the number of visits or days eligible for sharing for various types of office visit charges in the EasyShare Programs. For example, members are eligible for up to four combined Primary Care and Pediatric visits per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How long is the waiting period for medical expenses related to Maternity for members who have been continuous Sharing Members for at least twelve months prior to conception in the Healthy Life EasyShare Programs? [/INST] Assistant : For members who have been continuous Sharing Members for at least twelve months prior to conception, medical expenses related to Maternity become eligible for sharing without any waiting period, subject to the applicable Annual Non-Sharable Medical Amount. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Could you clarify what the Annual Non-Sharable Amount is in the Healthy Life EasyShare Programs and how it affects sharing? [/INST] Assistant : Certainly, the Healthy Life EasyShare Programs have an Annual Non-Sharable Amount of $0. This means that all eligible medical expenses can be shared, and there is no annual limit on non-sharable expenses. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the purpose of Consultation Fees in the Healthy Life EasyShare Programs, and how do they impact sharing? [/INST] Assistant : Consultation Fees in the EasyShare Programs are per-visit fees that members must pay at the time of their visit. These fees are never eligible for sharing and are the member's personal responsibility. They cover the cost of consultation with healthcare professionals. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain how sharing for imaging services like CT Scan, MRI, and X-Ray works in the Healthy Life EasyShare Programs? [/INST] Assistant : Certainly, for outpatient CT Scan, MRI, and X-Ray imaging services in the EasyShare Programs, there is a 90-day waiting period. Sharing eligibility is limited to two imaging services per year for each category. Members are responsible for any amount above the specified sharing limits. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, For the context of the Healthy Life EasyShare Programs, what does 'inpatient hospital stay' mean in relation to the sharing of Emergency Room and Ambulance expenses? [/INST] Assistant : In the EasyShare Programs, 'inpatient hospital stay' refers to a situation where a member is admitted to the hospital as an inpatient due to a medical condition that is life-threatening or could seriously jeopardize their health. Emergency Room and Ambulance expenses are shareable only if they result in such a hospital stay. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum amount of lifetime sharing available for members in the Healthy Life EasyShare Programs? [/INST] Assistant : The maximum amount of lifetime sharing available for members in the EasyShare Programs is $500,000 for EasyShare50 members and $250,000 for EasyShare25 members. These limits are in place to manage the long-term financial commitments of the program. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Are there any restrictions on the number of visits or days eligible for sharing for Inpatient Hospital Care in the Healthy Life EasyShare Programs? [/INST] Assistant : Yes, there is a limit of 10 days per Program Year for Inpatient Hospital Care eligible for sharing in the EasyShare Programs. Members can have up to 10 days of inpatient hospitalization shared per year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What are the criteria for sharing of expenses related to Ambulance services in the Healthy Life EasyShare Programs? [/INST] Assistant : In the EasyShare Programs, sharing for Ambulance services is limited to medical conditions that are life-threatening or could seriously jeopardize the health of the individual, and only when the illness or injury results in an in-patient hospital stay. If eligible, sharing is capped at $500 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain the criteria for sharing of expenses related to Preventive Services in the Healthy Life EasyShare Programs? [/INST] Assistant : Certainly, Preventive Services, including an Annual Routine Physical or Well Child Exam, are eligible for sharing after a 30-day waiting period. Members must pay a Consultation Fee for each visit, and the remaining portion of physician charges for the office visit becomes eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How do the Per Medical Incident Sharing Limits work in the Healthy Life EasyShare Programs, and what are the limits for Inpatient Hospitalization? [/INST] Assistant : The Per Medical Incident Sharing Limits in the EasyShare Programs specify the maximum amounts eligible for sharing for various medical incidents. For Inpatient Hospitalization, members can have up to 10 days shared, with a limit of up to $3,000 per day for room and board. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, what is the purpose of the waiting period before certain medical expenses become eligible for sharing? [/INST] Assistant : The waiting period in the Healthy Life EasyShare Programs serves to establish a specific time frame before certain medical expenses become eligible for sharing. This helps manage the financial commitments of the program and ensure that members meet certain criteria before sharing begins. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain the difference in waiting periods for Cologuard testing, Preventive Care, and other Medical Expense Needs in the Healthy Life EasyShare Programs? [/INST] Assistant : Certainly, in the Healthy Life EasyShare Programs, there is a 180-day waiting period for Cologuard testing, a 30-day waiting period for Preventive Care, including Annual Routine Physicals, and a 90-day waiting period for other Medical Expense Needs. These waiting periods vary based on the type of service to be shared. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How does the EasyShare Programs handle Consultation Fees for different types of visits, and are these fees shareable? [/INST] Assistant : In the EasyShare Programs, Consultation Fees vary depending on the type of visit, such as Telemedicine, Primary Care, Pediatrics, and Preventive Care. These fees are not eligible for sharing and are the responsibility of the member. After paying the Consultation Fee, the remaining portion of physician charges for the office visit is eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, For outpatient CT Scan, MRI, and X-Ray imaging in the Healthy Life EasyShare Programs, what are the specific waiting periods and sharing limits? [/INST] Assistant : Outpatient CT Scan, MRI, and X-Ray imaging services in the EasyShare Programs have a 90-day waiting period. Members can share up to two imaging services per year in each category, with specific sharing limits for each type of imaging. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How does the EasyShare Programs define a 'Medical Incident,' and what are the sharing limits associated with it? [/INST] Assistant : In the EasyShare Programs, a 'Medical Incident' includes various medical needs, such as Inpatient Hospitalization, Inpatient and Outpatient Surgery, Emergency Room visits, Ambulance services, CT Scans, MRIs, and X-Rays. Each type of Medical Incident has specific sharing limits, which vary based on the program (EasyShare50 or EasyShare25). </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you elaborate on the criteria for sharing of expenses related to Emergency Room services in the Healthy Life EasyShare Programs? [/INST] Assistant : Certainly, in the EasyShare Programs, sharing for Emergency Room services is limited to medical conditions that are life-threatening or could seriously jeopardize the health of the individual. Sharing is capped at up to $1,000 per incident for eligible emergency services resulting in an in-patient hospital stay. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the purpose of the Annual Visits & Hospitalization Sharing Limits in the Healthy Life EasyShare Programs, and how do they affect members? [/INST] Assistant : The Annual Visits & Hospitalization Sharing Limits in the EasyShare Programs set maximum numbers of visits, days, or incidents eligible for sharing for different types of medical needs in a Program Year. These limits ensure fair and controlled sharing while providing members with access to essential healthcare services. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Are there any restrictions on the number of visits or days eligible for sharing for Specialty Care in the Healthy Life EasyShare Programs? [/INST] Assistant : Yes, in the EasyShare Programs, there is a limit of 2 visits per Program Year eligible for sharing for Specialty Care. This ensures that members have access to specialized medical care while managing program resources. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the purpose of the Lifetime Sharing Limits in the Healthy Life EasyShare Programs, and how do they impact long-term sharing? [/INST] Assistant : The Lifetime Sharing Limits in the EasyShare Programs establish a maximum amount of sharing available to individual members over their lifetime. This helps manage the long-term financial commitments of the program and ensures sustainability. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you clarify the role of Annual Non-Sharable Amounts in the Healthy Life EasyShare Programs and how they affect sharing? [/INST] Assistant : Certainly, in the EasyShare Programs, there is no Annual Non-Sharable Amount. This means that there is no annual limit on non-sharable expenses, and all eligible medical expenses can be shared without this restriction. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How long does a member need to continuously participate in the Healthy Life EasyShare Programs before medical expenses for Maternity become eligible for sharing? [/INST] Assistant : A member needs to be a Sharing Member continuously for at least twelve (12) months prior to conception for medical expenses related to Maternity to become eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum amount of lifetime sharing available for a member in the EasyShare25 Program, and how does it differ from the EasyShare50 Program? [/INST] Assistant : The maximum amount of lifetime sharing available for an EasyShare25 member is $250,000, whereas for an EasyShare50 member, it's $500,000. This difference in lifetime sharing limits reflects the distinction between the two program tiers. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you explain the eligibility criteria for sharing expenses related to Ambulance or Emergency Room services in the Healthy Life EasyShare Programs? [/INST] Assistant : In the Healthy Life EasyShare Programs, sharing for Ambulance or Emergency Room services is intended for medical conditions that are life-threatening or could seriously jeopardize the health of the individual. Eligibility for sharing applies when the injury or illness results in an in-patient hospital stay. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Are there any specific requirements for sharing expenses related to Imaging services in the Healthy Life EasyShare Programs, and how do the limits work? [/INST] Assistant : Yes, there are specific requirements for sharing Imaging services. Members must have a physician's prescription, and these services must be obtained at a freestanding in-network diagnostic center. The sharing limits are up to $400 per imaging series for CT scans and MRIs and up to $250 per imaging series for X-rays. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the purpose of the Annual Sharing Limits in the Healthy Life EasyShare Programs, and how do they affect the maximum sharable amounts for members? [/INST] Assistant : The Annual Sharing Limits in the EasyShare Programs establish the maximum sharable amounts for any individual member in each program. For example, in EasyShare50, the Annual Combined Program Maximum is $50,000. These limits help manage the overall sharing capacity and ensure equitable distribution of resources among members. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Could you explain the difference between EasyShare50 and EasyShare25 programs in terms of their Annual Combined Program Maximum and Preventive Care sharing limits? [/INST] Assistant : Certainly, in the EasyShare50 program, the Annual Combined Program Maximum is $50,000, while in the EasyShare25 program, it's $25,000. Additionally, the Preventive Care sharing limit for Standard Programs is $500 per member per year in both program tiers. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the purpose of the Per Medical Incident Sharing Limits in the Healthy Life EasyShare Programs, and how do they impact the sharing of various medical expenses? [/INST] Assistant : The Per Medical Incident Sharing Limits in the EasyShare Programs establish specific limits for different types of medical expenses within each Medical Incident category. This ensures that members know the maximum amount eligible for sharing for each type of incident, such as Inpatient Hospitalization, Surgery, or Emergency Room visits. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Could you provide more details about the EasyShare Programs' handling of Consultation Fees and how they affect members' sharing eligibility? [/INST] Assistant : Certainly, in the EasyShare Programs, members must pay Consultation Fees for various types of visits. These fees are not eligible for sharing and are the personal responsibility of the member. However, after paying the Consultation Fee, the remaining portion of physician charges for the office visit may be eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How does the EasyShare Programs define 'Medical Incident,' and why is it important for members to understand this definition? [/INST] Assistant : In the EasyShare Programs, a 'Medical Incident' includes various medical needs such as Inpatient Hospitalization, Surgery, Emergency Room visits, and diagnostic imaging. Understanding this definition is crucial for members as it helps determine the sharing limits and eligibility criteria for different types of medical incidents. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, Can you clarify the annual sharing limits for Inpatient Hospital Care in the EasyShare Programs and how they work? [/INST] Assistant : Certainly, in the EasyShare Programs, the annual sharing limit for Inpatient Hospital Care is 10 days per Program Year. Members can have up to 10 days of Inpatient Hospital Care shared, and the program covers up to a specified amount for room and board expenses during those days. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for Medical Expense Needs related to Maternity in the Healthy Life EasyShare Programs, and what condition must a member meet to be eligible for sharing? [/INST] Assistant : The waiting period for Medical Expense Needs related to Maternity is twelve (12) months of continuous membership prior to conception. A member must be a Sharing Member for at least twelve months before conception to be eligible for sharing Maternity expenses. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Consultation Fee for Telemedicine visits in the EasyShare50 and EasyShare25 programs? [/INST] Assistant : The Consultation Fee for Telemedicine visits is $0 for both the EasyShare50 and EasyShare25 programs. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many incidents of Emergency Room visits are eligible for sharing in the EasyShare50 program, and what is the maximum sharing amount per incident? [/INST] Assistant : In the EasyShare50 program, members are eligible for sharing up to 2 incidents of Emergency Room visits per Program Year, with a maximum sharing amount of $1,000 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for sharing eligibility for all outpatient CT Scan, MRI, and X-Ray imaging in the EasyShare Programs, and how many imaging services are shareable per year? [/INST] Assistant : All outpatient CT Scan, MRI, and X-Ray imaging have a 90-day waiting period. Members can share up to two imaging series per year in each category. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Per-Surgical Procedure Limit for Inpatient and Outpatient Surgical Procedures in the EasyShare25 program, and how many surgical procedures are eligible for sharing per Program Year? [/INST] Assistant : In the EasyShare25 program, the Per-Surgical Procedure Limit for Inpatient and Outpatient Surgical Procedures is $2,500 per surgical procedure. Members can share up to two surgical procedures per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Per-Incident Limit for Ambulance services in the EasyShare Programs, and how many incidents are eligible for sharing per Program Year? [/INST] Assistant : The Per-Incident Limit for Ambulance services in both the EasyShare50 and EasyShare25 programs is $500 per incident. Members can share up to 2 incidents per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What are the Lifetime Sharing Limits for an EasyShare25 member and an EasyShare50 member? [/INST] Assistant : The Lifetime Sharing Limit for an EasyShare25 member is $250,000, while for an EasyShare50 member, it is $500,000. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Annual Non-Sharable Amount for Medical Expenses in the EasyShare Programs? [/INST] Assistant : The EasyShare Programs have an Annual Non-Sharable Amount of $0, meaning there is no annual non-sharable amount for medical expenses in these programs. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum Annual Combined Program Maximum for a member in the EasyShare25 program, and what does it include? [/INST] Assistant : In the EasyShare25 program, the maximum Annual Combined Program Maximum is $25,000. This includes the maximum sharable amount for all eligible medical expenses incurred throughout the Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for Cologuard testing to become eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : There is a 180-day waiting period before Cologuard testing may be eligible for sharing in the Healthy Life EasyShare Programs. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many incidents of Emergency Room visits are eligible for sharing in the EasyShare25 program, and what is the maximum sharing amount per incident? [/INST] Assistant : In the EasyShare25 program, members are eligible for sharing up to 2 incidents of Emergency Room visits per Program Year, with a maximum sharing amount of $1,000 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum lifetime sharing available for an EasyShare50 member, and what does it cover? [/INST] Assistant : The maximum lifetime sharing available for an EasyShare50 member is $500,000, and it covers all eligible medical expenses incurred throughout the member's lifetime. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for Preventive Care, including an Annual Routine Physical or Well Child Exam, to become eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : There is a 30-day waiting period before Preventive Care, including an Annual Routine Physical or Well Child Exam, may be eligible for sharing in the Healthy Life EasyShare Programs. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What are the Per-Medical-Incident Sharing Limits for Inpatient Hospitalization in the EasyShare25 program? [/INST] Assistant : For Inpatient Hospitalization in the EasyShare25 program, the sharing limit includes a maximum of 10 days per incident, and the eligible amount for room and board is up to $2,500 per day. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum number of visits/days/incidents eligible for sharing per Program Year for Primary Care combined with Pediatrics in the Healthy Life EasyShare Programs? [/INST] Assistant : For Primary Care combined with Pediatrics in the Healthy Life EasyShare Programs, members are eligible for sharing up to 4 visits in total for any combination of Primary Care and Pediatrics per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Per-Incident Limit for Ambulance services in the Healthy Life EasyShare Programs, and how many incidents are eligible for sharing per Program Year? [/INST] Assistant : The Per-Incident Limit for Ambulance services in both the EasyShare50 and EasyShare25 programs is $500 per incident, and members can share up to 2 incidents per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Annual Combined Program Maximum for the EasyShare50 program, and what does it cover? [/INST] Assistant : For the EasyShare50 program, the Annual Combined Program Maximum is $50,000. This includes the maximum sharable amount for all eligible medical expenses incurred throughout the Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum number of visits/days/incidents eligible for sharing per Program Year for Urgent Care in the Healthy Life EasyShare Programs? [/INST] Assistant : For Urgent Care in the Healthy Life EasyShare Programs, members are eligible for sharing up to 2 visits per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Per-Procedure Limit for CT Scan imaging in the EasyShare50 program? [/INST] Assistant : For CT Scan imaging in the EasyShare50 program, the Per-Procedure Limit is up to $400 per imaging series. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Annual Non-Sharable Amount for medical expenses in the Healthy Life EasyShare Programs? [/INST] Assistant : The Healthy Life EasyShare Programs have no annual Non-Sharable Amount; it is $0 for these Programs. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many incidents of Emergency Room visits are eligible for sharing in the EasyShare50 program, and what is the maximum sharing amount per incident? [/INST] Assistant : In the EasyShare50 program, members are eligible for sharing up to 2 incidents of Emergency Room visits per Program Year, with a maximum sharing amount of $1,000 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for Primary Care, Specialty Care, Pediatric, and Urgent Care office visit charges to become eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : There is no waiting period for sharing eligibility for Primary Care, Specialty Care, Pediatric, and Urgent Care office visit charges in the Healthy Life EasyShare Programs; they are immediately eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many incidents of Ambulance services are eligible for sharing in the EasyShare50 program, and what is the maximum sharing amount per incident? [/INST] Assistant : In the EasyShare50 program, members can share up to 2 incidents of Ambulance services per Program Year, with a maximum sharing amount of $500 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Per-Procedure Limit for MRI imaging in the EasyShare25 program? [/INST] Assistant : For MRI imaging in the EasyShare25 program, the Per-Procedure Limit is up to $400 per imaging series. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum number of visits/days/incidents eligible for sharing per Program Year for Inpatient Hospital Care in the Healthy Life EasyShare Programs? [/INST] Assistant : For Inpatient Hospital Care in the Healthy Life EasyShare Programs, members are eligible for sharing up to 10 days per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum Annual Sharing Limit for an individual Member in the EasyShare50 program? [/INST] Assistant : The Annual Sharing Limit for an individual Member in the EasyShare50 program is $50,000, inclusive of any other eligible sharable medical expenses incurred throughout the Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum amount of lifetime sharing available for an EasyShare25 member, and what does it cover? [/INST] Assistant : The maximum amount of lifetime sharing available for an EasyShare25 member is $250,000, and it covers all eligible medical expenses incurred throughout the member's lifetime. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many Per-Medical-Incident Sharing Limits apply to Inpatient and Outpatient Surgery in the EasyShare50 program? [/INST] Assistant : For Inpatient and Outpatient Surgery in the EasyShare50 program, there are 2 incidents per year, each with a Per-Incident Limit of up to $3,000 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for Medical Expense Needs related to Maternity to become eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : For a member who has been a Sharing Member continuously for at least twelve (12) months prior to conception, medical expenses for Maternity are eligible for sharing, subject to the applicable Annual Non-Sharable Medical Amount. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for Medical Expense Needs related to Cologuard testing to become eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : There is a 180-day waiting period before any Medical Expense Need for Cologuard testing may be eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many incidents of Inpatient Hospitalization are eligible for sharing in the EasyShare25 program, and what is the Per-Incident Limit for room and board charges? [/INST] Assistant : In the EasyShare25 program, members can share up to 10 incidents of Inpatient Hospitalization per year, with an eligible Per-Incident Limit of up to $2,500 for room and board charges. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum number of visits/days/incidents eligible for sharing per Program Year for Routine Annual Physical or Well Child Exams in the Healthy Life EasyShare Programs? [/INST] Assistant : For Routine Annual Physical or Well Child Exams in the Healthy Life EasyShare Programs, members are eligible for sharing up to 1 visit per Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Per-Procedure Limit for X-Ray imaging in the EasyShare50 program? [/INST] Assistant : For X-Ray imaging in the EasyShare50 program, the Per-Procedure Limit is up to $250 per imaging series. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many Per-Medical-Incident Sharing Limits apply to Urgent Care visits in the EasyShare50 program? [/INST] Assistant : For Urgent Care visits in the EasyShare50 program, there is a limit of 2 visits per Program Year, each with a Per-Incident Limit. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Annual Combined Program Maximum for the EasyShare25 program, and what specific category does it apply to? [/INST] Assistant : The Annual Combined Program Maximum for the EasyShare25 program is $25,000, and it applies to the total amount of medical expenses that may be shared for any individual member throughout the Program Year. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How does the EasyShare program handle sharing expenses for Ambulance or Emergency Room services? [/INST] Assistant : Sharing expenses for Ambulance or Emergency Room services in the EasyShare program are only intended for medical conditions that are life-threatening or could seriously jeopardize the health of the individual, and they are limited to specific maximum amounts per incident. For example, for eligible emergency services, the sharing limit is not more than $1,000 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the maximum Per-Incident Limit for Emergency Room visits in the EasyShare25 program? [/INST] Assistant : The maximum Per-Incident Limit for Emergency Room visits in the EasyShare25 program is $1,000. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many incidents of CT Scan imaging are eligible for sharing in the EasyShare50 program, and what is the Per-Procedure Limit? [/INST] Assistant : In the EasyShare50 program, members can share up to 2 incidents of CT Scan imaging per Program Year, with a Per-Procedure Limit of up to $400 per imaging series. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Per-Procedure Limit for Inpatient and Outpatient Surgical Procedures in the EasyShare50 program? [/INST] Assistant : For Inpatient and Outpatient Surgical Procedures in the EasyShare50 program, the Per-Procedure Limit is up to $3,000 per incident. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the waiting period for Preventive Care, including an Annual Routine Physical or Well Child Exam, to become eligible for sharing in the Healthy Life EasyShare Programs? [/INST] Assistant : There is a 30-day waiting period before any Medical Expense Need for Preventive Care, including an Annual Routine Physical or Well Child Exam, may be eligible for sharing. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, How many incidents of Inpatient and Outpatient Surgery are eligible for sharing in the EasyShare25 program, and what is the Per-Surgical Procedure Limit? [/INST] Assistant : In the EasyShare25 program, members can share up to 2 incidents of Inpatient and Outpatient Surgery per Program Year, with a Per-Surgical Procedure Limit of up to $2,500 per surgical procedure. </s> |
<s>[INST] For the Healthy Life EasyShare Programs, What is the Lifetime Sharing Limit for an EasyShare50 member? [/INST] Assistant : The maximum amount of lifetime sharing available for an EasyShare50 member is $500,000. </s> |
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