When you must be isolated to prevent contagion, it’s required by law or if only available

This amount applies to all
surgical procedures under Standard Option

The hours you may stay in the hospital after a regular and/or a cesarean delivery without obtaining precertification.

Standard Option member must get care within this time frame to receive accidental injury benefits

Questionnaire that entitles members to receive special benefit incentives.

A Basic Option member will pay this copayment amount when they are in a Preferred hospital for 10 days

The requirement for an inpatient admission which failure to obtain results in a $500 penalty

This will be waived when a Standard option member goes to a preferred hospital for delivery

The sudden & unexpected onset of a condition or injury that endangers your life or could result in a disability & requires immediate care

Basic Option member pays this for a routine physical when going to a non-participating provider.

A member must have Medicare A in order to receive these benefits

Cosmetic, Reversal of sterilization, standby physicians, LASIK

When a newborn requires definitive treatment, during or after the mothers confinement they become this

This is the facility co-pay for emergency room visits for Basic option.

Well child benefits are available up to this age as recommended by the American Academy of Pediatrics

An integrated set of services & supplies designed to provide palliative & supportive care to terminally ill patients

This type of surgery is only covered when morbid obesity is a health problem

Prenatal care, delivery & postpartum care.

Caused by an external force or element such as a blow or fall that requires immediate medical attention

Screening available to women age
65 and over, or 50-65 with increased risk

Homemaking, bathing, exercising, dressing etc

Surgery to correct a functional defect, a congenital anomaly, to restore the mouth to a pre-cancerous state and for all stages of breast surgery following a mastectomy

A Standard option member used a Non-Par doctor to deliver their baby, therefore they are responsible for this

A standard option member will pay this for ambulance services from a preferred provider related to an accidental injury

Hepatitis, Influenza, pneumococcal & tetanus-diphtheria