To get the most from your plan, know the answers to these basic questions:
All the details on covered services can be found in your contract.
The table below identifies all documents which make up the contract and the information each one provides.
|Document||information it provides|
|Certificate of Coverage||
|Outline of Coverage||
|Riders or Endorsements
(listed on outline of coverage)
The term "benefit" refers to any service (examples: office visits, surgical procedures) or supply (example: prescription drugs) covered by your health plan.
What are my benefits?
To find out what your specific benefits are, consult your contract.
How to use them?
To use your benefits properly you should verify coverage before you receive services. This will help you determine:
Present your ID card before you receive services.
In addition to your monthly premium, you are responsible for paying a portion for services received. Your plan will consist of one, or a combination of the following out-of-pocket expenses:
Unsure which type of out-of-pocket expense your plan has? View your Benefit Information within the Member Resource Center
Read the member newsletter, Vigor for up-to-date details on health plans and important policies that may affect services.