applicable deadline, we will not cover Post-Stabilization Care that you receive from a Non-Participating Provider or Non-Participating Facility. After we are notified, we will discuss your condition with the Non-Participating Provider. If we decide that the Post-Stabilization Care is Medically Necessary and would be covered if you received it from a Participating Provider or Participating Facility, we will either authorize the Services from the Non-Participating Provider or Non-Participating Facility, or arrange to have a Participating Provider or Participating Facility (or other designated provider, facility, or vendor) provide the Services. If we decide to arrange to have a Participating Provider or Participating Facility (or other designated provider or facility) provide the Services to you, we may authorize special transportation Services that are medically required to get you to the provider or facility. This may include transportation that is otherwise not covered. When you receive Emergency Services from Non-Participating Providers, Post Stabilization Care may qualify as Emergency Services pursuant to federal law. We will not require prior authorization for such Post- Stabilization Care when your attending Non-Participating Provider determines that, after you are Stabilized, and taking into account your medical or behavioral health condition, you are not able to travel to an available Participating Provider located within a reasonable travel distance, using non-medical transportation or non- emergency transportation. Urgent Care Inside our Service Area You may receive covered Urgent Care Services from Participating Providers, including Kaiser Permanente Urgent Care. Visit kp.org/getcare or call Member Services to find the Kaiser Permanente Urgent Care locations nearest you. Outside our Service Area If you are temporarily outside our Service Area, we cover Urgent Care you receive from a Non-Participating Provider or Non-Participating Facility if we determine that the Services were necessary to prevent serious deterioration of your health and that the Services could not be delayed until you returned to our Service Area. WHAT YOU PAY Deductible For each Year, most covered Services are subject to the Deductible amounts shown in the “Benefit Summary.” The “Benefit Summary” indicates which Services are subject to the Deductible. For Services that are subject to the Deductible, you must pay Charges for the Services when you receive them, until you meet your Deductible. If you are the only Member in your Family, then you must meet the self-only Deductible. If there is at least one other Member in your Family, then you must each meet the individual Family Member Deductible, or your Family must meet the Family Deductible, whichever occurs first. Each individual Family Member Deductible amount counts toward the Family Deductible amount. Once the Family Deductible is satisfied, no further individual Family Member Deductible will be due for the remainder of the Year. The Deductible amounts are shown in the “Benefit Summary.” After you meet the Deductible, you pay the applicable Copayments and Coinsurance for covered Services for the remainder of the Year until you meet your Out-of-Pocket Maximum (see “Out-of-Pocket Maximum” section). For each Year, only the following payments count toward your Deductible:  Charges you pay for covered Services you receive in that Year and that are subject to the Deductible. EWCLGDED1983ACT0124 37 WAPEBB-CL-ACT