PERS: Non-Medicare Eligible
Summary of covered services.
This plan covers the following health care services and more.
- Doctor office visits
- Emergency services
- Hospital care
- Lab services
- Mental health and substance use disorder services
- Outpatient care services
- Pregnancy and newborn care services
- Prescription drugs
- Preventive care services
- Rehabilitation services and devices
- Wellness services
This may not be a complete list of the services covered under this plan. See your health plan documents for coverage details.
How paying for network care works.
- You'll usually pay a copayment for certain covered services such as doctor visits and prescriptions.
- You'll usually have to pay a deductible before your plan will pay for covered services.
- You pay coinsurance, where you share a percentage of the cost with your plan.
- You are protected with an out-of-pocket limit. You'll never pay more than your out-of-pocket limit during the plan year. The out-of-pocket limit includes all of your network payments.
Note: You won't need to worry about these costs for age-appropriate preventive care if you stay in the network.
For certain services, you may be required to receive approval before they can be covered.