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Benefits at a Glance

We will pay the fixed benefit dollar amount for the following covered medical and surgical services. Availability, terms, conditions, limitations and exclusions may apply. Please refer to the Benefits Summary for the dollar amount and service limits of the specific plan.

Outpatient Benefits

  • Physician Office Visit
  • Diagnostic Lab
  • Diagnostic X-Ray
  • Emergency Room
  • Outpatient Surgery
  • Anesthesiology

Inpatient Benefits

  • Standard Care
  • Intensive Care
  • Inpatient Surgery
  • Anesthesiology

Prescription Drugs

Wellness Care