Page 67 - Appendices for Barbara Pender
P. 67
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
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 $30 copay Limits apply
with a psychiatrist
Outpatient individual $30 copay Limits apply
therapy with a psychiatrist
Outpatient group therapy $30 copay Limits apply
visit
Outpatient individual $30 copay Limits apply
therapy visit
