Page 57 - Appendices to Donald Pender's Evaluation
P. 57

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                       $50 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               $5 copay                               Limits apply
       with a psychiatrist




       Outpatient individual                  $5 copay                               Limits apply
       therapy with a psychiatrist





       Outpatient group therapy               $0 copay                               Limits apply
       visit





       Outpatient individual                  $0 copay                               Limits apply
       therapy visit
   52   53   54   55   56   57   58   59   60   61   62