A serious medical condition is defined as an illness, in the opinion of MyCare’s medical director, that:
Disability: A severe and prolonged impairment in physical or mental functions.
Hospital: A healthcare facility providing patient treatment with specialized medical and nursing staff and equipment.
Illness: Any unexpected and unforeseen condition or disease manifesting itself while the MyCare program is in force.
Inpatient: A person who is admitted to a hospital upon the recommendation of MyCare’s medical director as a patient for more than 15 consecutive hours and who receives medical treatment.
Major orthopedic: Procedures concerning bone and joint replacement and serious spine procedures.
Sickness: Any unexpected and unforeseen illness or disease manifesting itself while this plan is in force as to the member and which causes the plan member to incur medical expenses.