SBC - Primary Care Doctor and Specialist Visits, Preventive Care, Tests
The SBC explains the coverage level for seeing primary care doctors and specialists, as well as what's covered under preventive care. This will also detail what the plan covers for tests, like x-rays, MRIs, and blood work.
This is the standard format for all SBCs up until April 1, 2017. Please refer to the SBC in question for details specific to that plan. The layout may differ but the same information will exist.
On this page, we can:
- View high-level details on Copayment, Coinsurance, Allowed Amounts, and Network Coverage
- Determine In-Network and Out-of-Network coverage for common services.
- Primary care visits, like seeing your doctor for a cold
- Specialist visits, like a dermatologist
- Other practitioners, like a chiropractor or acupuncture (if covered)
- Preventive care, screenings, immunizations
- Tests: X-Rays, blood work, CT/PET scans, MRIs.
- Learn of any services that don't require the deductible to be met before receiving that benefit ("deductible waived").
- Be aware of important Limitations and Exceptions, like visit limits or preauthorization/precertification requirements.
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