Page 52 - APPENDICES for Janet Tuma
P. 52
Transportation services for non-emergency care: Plan-approved locations
Some coverage
Over the counter drug bene ts
Some coverage
In-home support services
Not covered
Home and bathroom safety devices
Not covered
Meals for short duration
Some coverage
Annual physical exams
Not covered
Telehealth
Some coverage
Worldwide emergency
Some coverage
SPECIAL BENEFITS
These benefits MIGHT apply to you if you have qualifying chronic illnesses, diseases, or other
factors. Contact plan to see if you qualify for these benefits before enrolling.
Reduced cost sharing for qualifying individuals
Some coverage
Drug coverage & costs
