47 in serious impairment to the individual's bodily functions; or (c) result in serious dysfunction of a bodily organ or part of the individual. “Stabilize” means the provision of medical treatment to you in an Emergency as may be necessary to assure, within reasonable medical probability that material deterioration of your condition is not likely to result from or during any of the following: • your discharge from an emergency department or other care setting where Emergency Care is provided to you; or • your transfer from an emergency department or other care setting to another facility; or • your transfer from a Hospital emergency department or other Hospital care setting to the Hospital's Inpatient setting. Emergency Care “Emergency Care” means a medical or behavioral health exam done in the Emergency Department of a Hospital or freestanding Emergency Facility, and includes services routinely available in the Emergency Department to evaluate an Emergency Condition. It includes any further medical or behavioral health exams and treatment required to stabilize the patient. Emergency Care may also include necessary services provided as part of the Emergency visit regardless of the department in which the services are provided. Medically Necessary services will be covered whether you get care from an In - Network or Out - of - Network Provider. Emergency Care you get from an Out - of - Network Provider will be covered as an In - Network service and will not require Precertification. For Sur prise Billing claims, the Out - of - Network Provider can only charge you any applicable Deductible, Coinsurance, and/or Copayment and cannot bill you for the difference between the Maximum Allowed Amount and their billed charges until your condition is stable and the Out of Network Provider has complied with the notice and consent process as described in the “Consolidated Appropriations Act of 2021 Notice” at the front of this Booklet. Your cost shares will be based on the Recognized Amount and will be applie d to your In - Network Deductible and In - Network Out - of - Pocket Limit. The Maximum Allowed Amount for Emergency Care from an Out - of - Network Provider will be determined using the median Plan In - Network contract rate we pay In - Network Providers for the geographic area where the service is provided for the same or similar services. If you are admitted to the Hospital from the Emergency Room, be sure that you or your Doctor calls us as soon as you are stabilized. We will review your care to decide if a Hospital stay is needed and how many days you should stay. See “Getting Approval for Benefits” for more details. Treatment you get after your condition has stabilized is not Emergency Care. Please refer to the “Consolidated Appropriations Act of 2021 Notice” at the front of this Booklet for more details on how this will impact your benefits. Gender Affirming Services This Plan provides benefits for gender affirming services, including gender affirming surgery for Members diagnosed with Gender Identity Disorder (also known as Gender Dysphoria). To be eligible for benefits, services must be Medically Necessary and all inpatient Facility admissions must be approved in advance through Precertification. Please refer to the “Getting Approval for Benefits” section for further details. Details on our medical policies are also available online at www.anthem.com/provider/policies/clinical - guidelines/ .