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Out of Area Coverage
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srcset="/sites/default/files/styles/main_menu_1440/public/2024-04/23-023_YaleHealth_484.jpg?h=deaec4b9&itok=cTW4Y7mB 1x" media="all and (min-width: 1440px)" type="image/jpeg" width="900" height="486"/> <img loading="eager" class="main_menu" src="/sites/default/files/styles/main_menu_1440/public/2024-04/23-023_YaleHealth_484.jpg?h=deaec4b9&itok=cTW4Y7mB" width="900" height="486" alt="children and parent in waiting area" /> </picture> </figure> </div> </div> </div> </details> </li> <li class="menu__item"> <a href="/forms-and-guidelines" data-drupal-link-system-path="node/911">Forms & Guidelines</a> </li> </ul> </nav> </div> <div class="site-header__tools"> <a href="/search" aria-label="Yale Health search page"> <i class="fal fa-search"></i><span class="visually-hidden">Search</span> </a> <button class="menu-toggle" data-js="menu-toggle" aria-controls="block-main" aria-expanded="false"> <span></span> <span></span> <span></span> </button> </div> </div> </header> <main id="site-main" class="site-main"> <div class="site-main__system"> <div class="region-system"> <div data-drupal-messages-fallback class="hidden"></div> </div> </div> <div class="region-content"> <div id="block-yale-health-content"> <article class="node node--topic-page node--full" data-js="node-topic_page"> <header class="node__header" data-js="node-header"> <h1 class="node__heading"> Out of Area Coverage </h1> </header> <div class="node__content"> <div class="node__sections"> <div class="layout layout--one-column"> <div class="layout__content"> <div class="layout__regions"> <div class="layout__region layout__region--content"> <div class="layout__region-item"> <div class="paragraph paragraph--html-content paragraph--default" data-js="html-content"> <div class="paragraph__body"> <div class="ck-content"> <p>Yale Health members and students with <a href="/node/654" data-entity-type="node" data-entity-uuid="aec4ecaf-35f3-45b7-896e-04b9d646f99f" data-entity-substitution="canonical">Yale Health Hospitalization/Specialty Care coverage</a> are covered outside of Connecticut for emergency care, acute care and pre-authorized short-term follow-up care.</p><p>An emergency medical condition is a sudden and severe condition, sickness or injury, including, but not limited to, severe pain, which would lead a prudent layperson, including the parent or guardian of a minor child or the parent or guardian of a disabled individual possessing an average knowledge of medicine and health, to believe that failure to get immediate medical care could result in:</p><ul><li>Placing one鈥檚 health in serious jeopardy</li><li>Serious impairment to a bodily function(s)</li><li>Serious dysfunction to a body part(s) or organ(s); or</li><li>In the case of a pregnant woman, serious jeopardy to the health of the unborn child.</li></ul><p><em>Important note for pregnant patients:</em> Starting from four weeks before your due date, or earlier if you are advised by your Yale Health clinician not to travel, charges associated with hospital admission will only be covered at Yale-New Haven Hospital.</p><h2>Using a Pharmacy Other than the Yale Health Pharmacy</h2><p>You can use any pharmacy. You will pay full price and then submit a <a href="/node/925" data-entity-type="node" data-entity-uuid="8b2bc0fc-bc89-41ed-88d1-974de15bd17d" data-entity-substitution="canonical" target="_blank">Pharmacy Claim Form</a>, which will be reviewed for reimbursement. Please note, your reimbursement is dependent upon the benefit (for more information visit <a href="/node/687" data-entity-type="node" data-entity-uuid="14479895-e4e8-4b8b-a5b1-a90262c0868f" data-entity-substitution="canonical">Coverage</a>) and formulary rules. For more information visit the <a href="/node/621" data-entity-type="node" data-entity-uuid="da162ed8-c2cd-449a-84e7-4f5fcd73c5d3" data-entity-substitution="canonical">Outside Pharmacy Use page</a>.</p><p>(If you are a student you need to have Yale Health Hospitalization/Specialty Care coverage in order to be reimbursed.)</p></div> </div> </div> </div> </div> </div> </div> </div> </div> <aside class="node__side-content"> <section class="node__resources"> <h2>Resources</h2> <article class="node-teaser node-teaser--resource node-teaser--label" data-js="node-resource"> <header class="node-teaser__header"> <div class="node-teaser__heading"> <a href="https://yalehealth.yale.edu/sites/default/files/2024-09/yale_health_prescription_claim_form.pdf" target="_blank"><i class="fal fa-file-pdf"></i><div><span>Pharmacy Claim Form</span></div></a> </div> </header> <div class="node-teaser__content"> </div> </article> <article class="node-teaser node-teaser--resource node-teaser--label" 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