CORE D
Sep 29, 2020, 09:42 AM
Title :
CORE D
Primary Care Visit Copay :
$0
Specialist Visit Copay :
$45
Dental Benefit :
$300 reimbursement limit
Includes Rx :
Yes
Preventive Services :
Yes
Prescription Drug Coverage :
Yes
Over-the-Counter Benefit Card :
Yes
Meal Delivery (Delivery of 20 meals after hospital stay. Limited 4 times/calendar year.) :
No
Telehealth / Virtual Visits Copay :
No
Travel Benefit :
Yes
Fitness Benefit :
Yes
Sort :
1
$0
$5,900
$50/visit
$90/visit
$15
Days 1-5: $370/day
Days 6+: $0
$250 per surgery
Days 1-20: $0
Days 21-100: $170/day
$48.10
Initial routine eye exam each year:
$0 copay
Plan pays $100 per year
for frames, lenses, and contacts
Annual hearing exam: $45
Hearing aids: $700-$1,050 per aid
Limit: 1 per ear, per year
6 (60-minute) visits per year: $20
Looking for pharmacy benefits information? Check out our drug coverage page.
2 Includes annual check and Medicare-approved vaccines, screenings, and tests
4 See the chart
5 Get reimbursed for dental services from a dentist you choose. Reimbursement limits: Core D=$300/Value D=$500/Elite D=$700/Value = $500/Elite=$700
7 Covers $50 OTC health-related items per quarter
8 20 meals delivered after a covered facility stay. Limited 4 times/year
10 $25/month reimbursement for an licensed facility
