PLAN BENEFITS

• Doctor’s Office Visits
• Prescription Drug Card (Rx Card) (en Español)
• Allergy Shots and Immunizations
• Outpatient Medical Benefits
• Surgical Benefits
• Anesthesia & Assisted Surgeon Benefits
• Ground and Air Ambulance
• Emergency Room or Urgent Care
• Inpatient Hospital Confinement
• Hospital Admission Benefits
• You may receive benefits for a maximum of $2 million of Lifetime benefit
• Pre-existing Conditions Benefits after 12 months

PLAN INFORMATION

Health Plans - Spreadsheet
Health Plans - Rate Sheet
Prescription Drug Card (Rx Card) (en Español)

PPO Networks