Coverage and benefits
View and print member ID cardsYour network medical account summary
View all spendingundefined's deductible
$XX.XX spent
$X,XXX.XX
Family deductible
$XX.XX spent
$X,XXX.XX
undefined's out-of-pocket limit
$XX.XX spent
$X,XXX.XX
Family out-of-pocket limit
$XX.XX spent
$X,XXX.XX
On this page
Medical
Your plan
- Plan name
- XXXXXXXX
- XXXXXXXX
- Member covered
- XXXXXXXX
- Referral
- XXXXXXXX
Services not covered
We do not pay benefits for services not covered, even if it is recommended or prescribed by a doctor and even if it is the only available treatment for your condition.
All exclusionsCheck for recent network or coverage changes
Changes can happen anytime within the plan year and this may significantly impact your healthcare costs. If there are any changes to your recent providers, medications, or pharmacies, we’ll let you know here.
Get the most out of your plan
Learn how your plan works
We've made a video that is personalized with your plan information.
Tips to avoid costs
Learn how to avoid surprise out-of-pocket costs for routine care.
Notices about this plan (3)
1. This is only a summary.
If there is a difference between this summary and your plan documents, the terms of your plan documents will apply.
2. These costs are estimates only.
The costs provided here are estimates only and are not a guarantee of payment or benefits. The estimates are based on the selected provider's contract rates/fee schedule or claims averages. Your actual cost may be higher or lower than the estimate for various reasons.
3. PDF documents
This page contains PDF documents (Portable Document Format). PDF files can be viewed with Adobe Reader. If you don't already have this viewer, download for free at Adobe.com(Opens new window)