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One routine prostate-antigen (PSA) blood test each calendar year for a member age 40 or older.

This health plan covers hospice services furnished by a Hospice Provider up to the dollar amount described in the benefit limit. These covered services include:

Inpatient and outpatient services furnished by a Physician, Psychologist or other Medicare covered mental health provider, including a Licensed Independent Clinical Social Worker or by a Clinical Specialist in Psychiatric and Mental Health Nursing or Licensed Mental Health Counselor. These benefits are provided for as many days/visits as are medically necessary, except that inpatient services in a Mental Hospital are limited to 120 days per benefit period (but at least 60 days each calendar year) for services not covered by Medicare; and outpatient services are limited to 16 visits each calendar year (the value for these visits is at least $1,000 per calendar year).

Routine medical exams furnished by a Physician or Nurse Practitioner.

This Medex plan covers routine hearing exam furnished by a Physician (who is an otologist or otolaryngologist) or an Audiologist under the direction of a Physician.

These covered services also include:

Hearing aid evaluation tests up to $40.

One hearing aid for each ear (or one set of binaural hearing aids). This includes dispensing fees and acquisition costs.

One follow-up visit up to $40 after a hearing aid is obtained.

Prescription lenses for up to $60 per set once every 12 months.