Page 13 - QCS.19 Employee Benefits
P. 13
Common Services You May Need Network Prov
Medical Event (You will pay the
Childbirth/delivery professional 0% coinsurance
services
Childbirth/delivery facility 0% coinsurance
services
Home health care 0% coinsurance
Rehabilitation services 0% coinsurance
Habilitation services 0% coinsurance
If you need help Skilled nursing care 0% coinsurance
recovering or have
other special health
needs
Durable medical equipment 0% coinsurance
Hospice services 0% coinsurance
If your child needs Children’s eye exam Not covered
dental or eye care Children’s glasses Not covered
Children’s dental check-up Not covered
* For more information about limitations and exceptions, see the plan or policydocu
