Unite Here Health
Thorek Hospital & Medical Center Benefits
If you or your covered dependents are treated at Thorek Hospital and Medical Center, the Plan provides the benefits described below for allowable chargers incurred during a Coverage Period.
What the Plan Pays
- 100% of outpatient hospital services, including 24-hour emergency treatment;
- 100% for inpatient hospital services, including 24-hour emergency treatment, up to a $25,000 maximum.
- Charges for services in excess of $25,000 are payable at 80%, subject to the Plan's deductible requirements.
- 100% for services furnished by doctors on the medical staff of Thorek, if the doctor is participating in the BCBSIL network and is also a member of the Thorek Family Health Network.
- 100% for outpatient mental health services furnished by licensed clinical psychologists who participate in the BCBSIL network and are also members of the Thorek Family Health Network.
- Services by other doctors are considered under the Comprehensive Major Medical Benefit.
Services and supplies furnished at Thorek Hospital and Medical Center are not eligible for benefits under the Plan's Comprehensive Major Medical provisions. However, the Trustees have the sole authority to determine the benefit levels applicable to services Thorek Hospital and Medical Center is temporarily unable to provide when those services, for reasons other than the provider's or patient's convenience, cannot be postponed and are furnished by another network provider before those services are again available at Thorek Hospital and Medical Center.
All Thorek Hospital and Medical Center Benefits paid by the Plan will be used to reduce the Comprehensive Major Medical Benefits maximums described here on Page 26.
The Plan covers services received at Thorek Memorial Hospital and Medical Center, but only to the extent they correspond tot he covered expenses described under the Plan's Comprehensive Major Medical Benefits, Pages 24-31.
What's Not Covered
In addition to the Plan's General Exclusions and Limitations, Pages 46-47, no Thorek Hospital and Medical Center Benefits will be paid for:
- Services at other facilities through a referral from Thorek Hospital and Medical Center or its doctors; and
- Services and supplies excluded by the Plan's Comprehensive Major Medical Benefit, Pages 24-31.