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The value of the outpatient benefit limit will be at least $500 combined for all mental health and substance use treatment for each member in each calendar year (plus $500 more for alcoholism).

The value of the outpatient benefit limit will be at least $500 combined for all mental health and substance use treatment for each member in each calendar year (plus $500 more for alcoholism).

These outpatient benefit limits do not apply to electric shock therapy.

Injectable insulin and disposable syringes and needles needed for its administration, whether or not a prescription is required. If insulin, syringes and needles are bought at the same time, the member pays one copayment.

For certain maintenance drugs and supplies from a retail pharmacy, the member pays only one copayment for up to a 100-day supply. This includes certain drugs for certain long-term conditions, insulin and disposable syringes and needles.

Treatment to repair and/or replace sound, natural teeth damaged due to accidental injury. These benefits include dental accident treatment and dental prostheses (such as dentures, bridges, braces and other such dental appliances). No benefits are provided for dental care following an injury caused by biting or chewing.

A routine fecal occult blood test once each year for a member age 50 or older.

For chiropractic services not covered by Medicare, Medex pays benefits for all services within the Chiropractor's scope of practice (such as lab tests and x-rays).

For Medicare-approved Skilled Nursing Facility services, Medex pays the Medicare Part A coinsurance from day 21 to day 100 in a benefit period. Then, Medex pays $18 for each day from day 101 to day 365 in the benefit period. The member pays all charges that are more than $18 a day starting on day 101 in the benefit period.

For a Skilled Nursing Facility that does not participate with Medicare, Medex pays $18 each day from day 1 to day 365 in the benefit period. The member pays all charges that are more than $18 a day.