Page 51 - APPENDICES for Janet Tuma
P. 51
Eyeglass frames (only)
$0 copay
Limits apply
Eyeglass lenses (only)
$0 copay
Limits apply
Upgrades
$0 copay
Limits apply
MEDICALLY-APPROVED NON-OPIOID PAIN MANAGEMENT SERVICES
Chiropractic services
Not covered
Acupuncture
Not covered
Massage therapy
Not covered
Alternative therapies
Not covered
MORE BENEFITS
Fitness bene t
Some coverage
Transportation services for non-emergency care: Any health-related locations
Not covered
