He, His, Him Refers to any individual, male or female. Hospital An institution that meets all of the following: 1. it is licensed as a Hospital pursuant to applicable law; 2. it is primarily and continuously engaged in providing medical care and treatment to sick and injured persons; 3. it is managed under the supervision of a staff of medical doctors; 4. it provides 24-hour nursing services by or under the supervision of a graduate registered nurse (R.N.); 5. it has medical, diagnostic and treatment facilities, with major surgical facilities on its premises, or available on a prearranged basis; 6. it charges for its services. The term Hospital does not include a clinic, facility, or unit of a Hospital for: 1. rehabilitation, convalescent, custodial, educational or nursing care; 2. the aged, drug addicts or alcoholics; 3. a Veteran’s Administration Hospital or Federal Government Hospital unless the Covered Person incurs an expense. Inpatient A Covered Person who is confined for at least one full day’s Hospital room and board. The requirement that a person be charged for room and board does not apply to confinement in a Veteran’s Administration Hospital or Federal Government Hospital and in such case, the term ''Inpatient'' shall mean a Covered Person who is required to be confined for a period of at least a full day as determined by the Hospital. Nurse A licensed graduate Registered Nurse (R.N.), a licensed practical Nurse (L.P.N.) or a licensed vocational Nurse (L.V.N.) and who is not: 1. employed or retained by the Subscriber; 2. living in the Covered Person’s household; or 3. a parent, sibling, spouse or child of the Covered Person. Outpatient A Covered Person who receives treatment, services and supplies while not an Inpatient in a Hospital. Physician A licensed health care provider practicing within the scope of his license and rendering care and treatment to a Covered Person that is appropriate for the condition and locality and who is not: 1. employed or retained by the Subscriber; 2. living in the Covered Person’s household; 3. a parent, sibling, spouse or child of the Covered Person. Prior Plan The plan of insurance providing similar benefits, sponsored by the Employer in effect immediately prior to this Policy’s Effective Date. Sickness A physical or mental illness. Subscriber Any participating organization that subscribes to the trust to which this Policy is issued. 4
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