2 Includes annual checkup and Medicare-approved vaccines, screenings, and tests.
3 An initial 3-day hospital stay is required
4 See chart
5 Reimbursement Limits by plan: Core D: $250/Value D: $350/Elite D: $550/Value: $350/Elite: $550
6 Get an extra $1,000 in dental coverage for a monthly fee
7 Covers $25 OTC health-related items per quarter
8 20 meals delivered after a covered facility stay. Limited 4 times/year.
9 Get covered care when you travel at in-network costs for travel outside of Wisconsin, Illinois, Minnesota, or Iowa.*
10$25/month reimbursement for any licensed facility.