Skip to main content
Find a Lawyer

Wisconsin Statutes Insurance (Ch. 600 to 655) § 632.85. Coverage without prior authorization for treatment of an emergency medical condition

Current as of January 01, 2025 | Updated by Findlaw Staff

(1) In this section:

(a) “Emergency medical condition” means a medical condition that manifests itself by acute symptoms of sufficient severity, including severe pain, to lead a prudent layperson who possesses an average knowledge of health and medicine to reasonably conclude that a lack of immediate medical attention will likely result in any of the following:

1. Serious jeopardy to the person's health or, with respect to a pregnant woman, serious jeopardy to the health of the woman or her unborn child.

2. Serious impairment to the person's bodily functions.

3. Serious dysfunction of one or more of the person's body organs or parts.

(b) “Health care plan” has the meaning given in s. 628.36 (2) (a) 1.

(c) “Self-insured health plan” means a self-insured health plan of the state or a county, city, village, town or school district.

(2) If a health care plan or a self-insured health plan provides coverage of any emergency medical services, the health care plan or self-insured health plan shall provide coverage of emergency medical services that are provided in a hospital emergency facility and that are needed to evaluate or stabilize, as defined in section 1867 of the federal Social Security Act, an emergency medical condition.

(3) A health care plan or a self-insured health plan that is required to provide the coverage under sub. (2) may not require prior authorization for the provision or coverage of the emergency medical services specified in sub. (2).

Previous Part of Code Next Part of Code
Back to Chapter List

Cite this article: FindLaw.com - Wisconsin Statutes Insurance (Ch. 600 to 655) § 632.85. Coverage without prior authorization for treatment of an emergency medical condition - last updated January 01, 2025 | https://codes.findlaw.com/wi/insurance-ch-600-to-655/wi-st-632-85/

FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.

Was this helpful?

Welcome to FindLaw's Cases & Codes

A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw’s Learn About the Law.

Go to Learn About the Law

Latest Blog Posts

For Legal Professionals

Learn About The Law

Get help with your legal needs

FindLaw’s Learn About the Law features thousands of informational articles to help you understand your options. And if you’re ready to hire an attorney, find one in your area who can help.

Go to Learn About the Law

Need to Find an Attorney?

Search our directory by legal issue

Enter information in one or both fields (Required)

Copied to clipboard