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Who might benefit most from a

copay plan?

•

Anyone who prefers the convenience of copay

benefits for routine health care expenses.

•

Families with young children who have

regularly scheduled doctor office visits.

•

Adults who want copay benefits for preventive

care and prescription drugs.

Copay Plans

Convenient doctor office copay benefits

When you use a Preferred Network doctor for an office visit, we pay 100% of history and exam fees after

a $25 copay.

Adult and Child Preventive Care included

Preventive Care office visits are covered the same as other doctor office visits -- with copay benefits.

Prescription drug card benefits

• Generic drugs -- $15 copay

• Name-brand drugs -- $100 per person, calendar-year deductible, then:

– $30 copay for preferred brands

– $60 copay for non-preferred brands

Comprehensive Coverage for inpatient and outpatient medical expenses

• Up to $3 million lifetime maximum benefit per covered person

• Covered inpatient and outpatient expenses are reimbursed at 80% once the deductible has been met

Copay Saver

SM

The Copay Saver

SM

plan provides the convenience of copays for doctor office visits (limited to 2 visits

per person, per calendar year) and generic prescription drugs for a lower monthly premium.

How Copay Select

SM

Works