Louisiana Administrative Code
Title 37 - INSURANCE Part
Part XIII - Regulations
Chapter 31 - Regulation 53-Basic Health Insurance Plan Pilot Program
Section XIII-3131 - Emergency Room Benefits
Universal Citation: LA Admin Code XIII-3131
Current through Register Vol. 50, No. 9, September 20, 2024
A. The LA Health Plan provides for the following emergency room benefits:
1. outpatient health care received in the
emergency room of a participating hospital is covered, limited to a maximum of
$1,500 per insured per calendar year. This benefit is subject to an $85
co-payment per visit;
2. the
co-payment of $85 per visit shall be waived if such a visit is followed by an
admission to the participating hospital for the care of the illness or injury
for which the person was treated in the emergency room.
B. An insured receiving emergency room care resulting from an illness or injury outside the service area of the authorized carrier shall have benefits of 50 percent of those for services received at a participating hospital.
AUTHORITY NOTE: Promulgated in accordance with R.S. 22:244-247 of the Insurance Code.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
