Search

First accident treatment received within three calendar days of a traumatic injury when the services are furnished by a Physician, Dentist or Nurse Practitioner.

The benefit limit dollar amount does not apply to: routine sigmoidoscopies or barium enemas; and routine colonoscopies.

Note: For covered organ transplants, these benefits are also provided for transportation and lodging costs. These benefits are provided for the transplant recipient who is a member and one companion (or two companions if the transplant recipient is an enrolled minor dependent child).

Note: For covered organ transplants, these benefits are also provided for transportation and lodging costs.

Outpatient family therapy services for enrolled dependent children under age 19. The outpatient benefit limit does not apply to these covered services.

Routine prostate specific antigen (PSA) blood tests (at least one test each calendar year for a member age 40 or older).

Routine mammograms.

A colonoscopy once every five years for a member age 50 or older.

Medical care services to diagnose or treat an illness or injury. This includes medical exams and contact lenses (plus the fitting of these contact lenses) that are needed to treat keratoconus. (It also includes certain services that have been approved to be furnished by a Limited Services Clinic on or after September 1, 2008.)

Note: Routine tests and newborn hearing screening tests do not count toward the benefit limit.