A Serious Medical Condition is defined as an illness, in the opinion of MyCare’s Medical Director, that:
Disability: Means 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.