Charges for office visits at participating providers for well-child visits, chemotherapy, hemodialysis, radiation therapy are covered at no cost to staff and eligible dependents. Other office visits are subject to a copay. Charges at nonparticipating providers are reimbursed at 80 percent after the deductible has been satisfied. Mandatory prospective procedure review provision applies to selected surgical and diagnostic procedures. See plan booklet for details.
Ambulatory surgery is required for certain procedures.
See plan booklet for details. Paid in full benefits are available for mental health, substance abuse, and home care services and equipment you may require at home. Precertification and use of participating providers is required. Prescription Drugs Mandatory Generic Substitution Requirement Participants pay a copay for each prescription filled through participating pharmacies. Participants must pay a copay for each prescription or refill.