Outpatient

Outpatient Care as of 1/1/09
Covered Services Your Cost
* No dollar limit applies when durable medical equipment is furnished as part of covered home dialysis, home health care, or hospice services.
** No limit applies when short-term rehabilitation therapy is furnished as part of covered home health care.
Office visits $15 per visit
Well-child care $15 per visit
Routine checkups
(including one gynecological exam per calendar year)
$15 per visit
Emergency room visits
(waived for observation stay or if admitted)
$40 per visit
Maternity care Nothing
Allergy injections only Nothing
Diagnostic X-rays, laboratory tests, and other tests Nothing
Oxygen and equipment for its administration Nothing
Hearing exams $15 per visit
Routine vision exams (one exam per year) $15 per visit
Family planning and infertility services $15 per visit
Chiropractic services
(up to 18 visits per calendar year for members age 16 or older)
$15 per visit
Home health care, including hospice care Nothing
Durable medical equipment (i.e., wheelchairs, crutches, hospital beds, and prosthetic devices, including repairs)
(up to a maximum of $15,000 per calendar year*)
All charges after $15,000 benefit maximum has been met
Short-term rehabilitation therapy**
 (physical and occupational)
$15 per visit
Speech, hearing, and language disorder treatment $15 per visit