X hits on this document

69 views

0 shares

0 downloads

0 comments

2 / 19

State of Michigan

Comparison of Health Care Options

Disclaimer

This is intended as an easy-to-read summary. It is not a contract. Additional limitations and exclusions may apply to covered services. Payment amounts are based on the Blue Cross Blue Shield of Michigan approved amount, less any applicable deductible and /or co-pay amounts required by the State Health Plan PPO. This coverage is provided pursuant to a contract entered into in the State of Michigan and shall be construed under the jurisdiction and according to the laws of the State of Michigan. MSPTA members should reference the Benefit Comparison Chart for Members of the State Police Enlisted Unit.

Preventive Services

$1,500 per year per person (State Health Plan PPO only)

State Health Plan PPO

HMO Benefits

In-network

Out-of-network

Health maintenance exam

Covered 100% 1 per year

Not Covered

Annual gynecological exam

Pap smear screening – laboratory services only

1

Well-baby and child care

Covered 100% 1 per calendar year

Not Covered

Covered 100% 1 per year

Not Covered

Covered 100%

Not Covered

Immunizations 2, annual flu shot & Hepatitis C screening for those at risk

Covered 100%

Not Covered

Covered 100% after $10 office visit co-payment

Covered 100%

Not Covered

Covered 100%

Not Covered

Covered 100%

Not Covered

Covered 100% one per year

Not Covered

Fecal occult blood screening

Flexible sigmoidoscopy

1

1

Colonoscopy

1&2

Prostate specific antigen screening 1

1

2

American Cancer Society guidelines apply Childhood immunizations and colonoscopy exams are excluded from the maximum limit

2

Document info
Document views69
Page views69
Page last viewedSat Jan 21 21:37:29 UTC 2017
Pages19
Paragraphs2099
Words4748

Comments