Page 16 - PWH.19 Employee Benefits
P. 16
Common Services You May Need W
Medical Event In-Network Prov
(You will pay the
Physician/surgeon fees 0% coinsuranc
Outpatient services Office Visit
0% coinsuranc
If you need Other Outpatie
mental health, 0% coinsuranc
behavioral health,
or substance 0% coinsuranc
abuse services
Inpatient services
If you are Office visits 0% coinsuranc
pregnant Childbirth/delivery professional 0% coinsuranc
services
Childbirth/delivery facility 0% coinsuranc
services
If you need help Home health care 0% coinsuranc
recovering or have
other special Rehabilitation services 0% coinsuranc
health needs Habilitation services 0% coinsuranc
Skilled nursing care 0% coinsuranc
Durable medical equipment 0% coinsuranc
* For more information about limitations and exceptions, see plan or policy d
