Page 53 - Appendices for Barbara Pender
P. 53

PREVENTIVE SERVICES


   Health care to prevent illness or detect illness at an early stage, when treatment is likely
   to work best (like Pap tests,  u shots, and screening mammograms).

   Learn more about your costs for preventive services




       Preventive services                    $0 copay                               Limits apply




   AMBULANCE



       Ground ambulance                       $100 copay




   THERAPY SERVICES




       Occupational therapy visit             $0 copay                               Limits apply




       Physical therapy & speech              $0 copay                               Limits apply
       & language therapy visit




   MENTAL HEALTH SERVICES




       Outpatient group therapy               $0 copay                               Limits apply
       with a psychiatrist




       Outpatient individual                  $0 copay                               Limits apply
       therapy with a psychiatrist





       Outpatient group therapy               $0 copay                               Limits apply
       visit





       Outpatient individual                  $0 copay                               Limits apply
       therapy visit
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