X hits on this document

248 views

0 shares

0 downloads

0 comments

15 / 113

Do These Expenses Count Towards The Coinsurance Maximum?

YES

NO

  • Utilization review penalties

  • Services not covered by the Plan including all those found in the Medical Limitations and Exclusions section

  • Prescription drug co-payments

  • Generic drug differential amounts

  • Services not considered medically necessary

  • The private room co-payment

  • The emergency room co-payment

Individual Prescription Drug Deductible Before the Plan will pay any of the cost for prescription drugs, each participant must first satisfy a $50 prescription drug deductible each calendar year.

The prescription drug deductible and co-payment amounts will not apply toward satisfying the medical calendar year deductible or coinsurance maximum. Prescription drug benefits paid by the Plan will apply toward the participant’s $1,000,000 lifetime maximum.

8

Document info
Document views248
Page views248
Page last viewedMon Dec 05 14:52:56 UTC 2016
Pages113
Paragraphs2271
Words37586

Comments