Coverage applies to visit with doctor, physician's assistance, nurse practitioner or nurse midwife. Copayments or coinsurance may vary according to the type and time of the visit. For example, there may be a higher copayment for after-hours care. Prescribed x-ray, laboratory and other diagnostic medical procedures. Screening mammograms available without referral .
Prior approval is required for some services, such as MRIs.
Visit limits may apply. Respiratory therapy limited to a maximum of 30 visits per calendar year. Allergy Testing Covered. Also covers diabetic outpatient self-management training and educational services. Limits may apply.