2021 Bright Health Plan Bronze – HMO Options


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2021 Plan Comparison
2021 Drug Formulary
$0 Rx List (including contraceptives)
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Bright Health Bronze Overview

Bright Health Bronze Plans have lower premiums and higher deductibles. These are best for healthy individuals who want to minimize their monthly premiums and are comfortable with the risk of a higher deductible in the event of a high-cost incident.

Advanced Premium Tax Credits (APTC) can be used to lower monthly premium payments if you quality.

Bright Health Bronze plans have been rated #2 and #4 by price and #1 in value and network in Cook County.

Bright Health has a total of 4 Bronze plans.

 

 

Bright Health Bronze $0 Primary Care

Download Summary of Benefits and Coverage here
Plan Guide here
Find a doctor here

Important Questions Answers Why this Matters:
What is the overall deductible?$7,200 Individual or
$14,400 Family
See the Common Medical Events chart below for your costs for services this plan covers.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible.
Are there services covered before you meet your deductible?Yes. Primary Care, Urgent Care and Generic Drugs are covered without a deductible.This plan covers some items and services even if you haven’t yet met the deductible amount. But a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost sharing and before you meet your deductible. See a list of covered preventive services at https://www.healthcare.gov/coverage/preventive-care-benefits/.
Are there other
deductibles for specific
services?
NoYou don’t have to meet deductibles for specific services
What is the out-of-pocket
limit for this plan?
$8,550 Individual or
$17,100 Family
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met.
What is not included in
the out-of-pocket limit?
Premiums, balance-billed charges, and health care this plan doesn’t cover.Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if you use a network provider? Yes. See
https://brighthealthplan.com/provider-finder/ifp or call 1-855-827-4448 for a list of network providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services.
Do you need a referral to
see a specialist?
YesThis plan will pay some or all of the costs to see a specialist for covered services but only if you have a referral before you see the specialist.
Common Medical EventServices You May Need

Your cost if you use
a Participating
Provider (You will pay the least)

Your cost if you use
a Non-Participating
Provider (You will pay the most)

Limitations & Exceptions, & Other Important Information
If you visit a health care provider’s office or clinicPrimary care visit to treat an injury or illness

 No charge

Not covered

None
Specialist visit

50%

Not covered

None
Preventive care/screening/immunization

No charge

Not covered

You may have to pay for services that aren’t preventive. Ask your provider if the services needed are preventive. Then check what your plan will pay for.
If you have a testDiagnostic test (x-ray, blood work)

50%

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
Imaging (CT / PET scans, MRIs)

50%

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
If you need drugs to treat
your illness or condition.
More information about
prescription drug coverage
is available at
www.brighthealthplan.com
Generic drugs (Tier 2)

$25

Not coveredTier 1 drugs are Preventive medications that are of $0 cost to you. Copays shown reflect the cost per retail prescription for a 30-day supply. Mail Order copays are 2.5 times the Retail cost for a 90-day supply
Preferred brand drugs (Tier 3)

50%

Not covered
Non-preferred brand drugs
(Tier 4)

50%

Not covered

Specialty drugs (Tier5)

50%

Not covered

If you have outpatient
surgery
Facility fee (e.g., ambulatory surgery center)

50%

Not covered

Services require pre-authorization.
Physician/surgeon fees

50%

Not covered

If you need immediate
medical attention
Emergency room care

50%

50%

None
Emergency medical transportation

50%

50%

None
Urgent care

$50

$50

None
If you have a hospital
stay
Facility fee (e.g., hospital room)

50%

Not covered

Services require pre-authorization.
Physician/surgeon fee

50%

Not covered

If you have mental
health, behavioral
health, or substance
abuse needs
Outpatient services50%

Not covered

None
Inpatient services

50%

Not covered

Services require pre-authorization.
If you are pregnantOffice visits

No charge

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
Childbirth/delivery professional services

50%

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
Childbirth/delivery facility services

50%

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
If you need help
recovering or have other special health needs
Home health care

50%

Not covered

Services require pre-authorization
Rehabilitation services

50%

Not covered

Habilitation services

50%

Not covered

Skilled nursing care

50%

Not covered

Durable medical equipment

50%

Not covered

Services require pre-authorization.
Hospice service50%

Not covered

Services require pre-authorization.
If your child needs
dental or eye care
Children’s eye exam

No Charge

Not covered

Limited to 1 eye exam per calendar year through the end of the month in which the dependent child turns19.
Children’s glasses

No Charge

Not covered

Limited to 1 pair of glasses including standard frames and standard lenses, or a one-year supply of contact lenses through the end of the month in which the dependent child turns 19.
Children’s dental check-up

Not Covered

Not Covered

Includes diagnostic and preventive services for dependent children through the end of the month in which the dependent child turns 19. Refer to the policy for covered services and limitations.

Excluded Services & Other Covered Services:

Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)
  • Acupuncture
  • Cosmetic Surgery
  • Dental care (Adults)
  • Long-term care
  • Non-emergency care when traveling outside the U.S.
  • Routine eye care (Adults)
  • Weight loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
  • Abortion care
  • Bariatric surgery
  • Chiropractic care
  • Hearing aids
  • Infertility treatment
  • Private-duty nursing
  • Routine foot care (for diabetes)

Bright Health Bronze $0 Medical Deductible

Download Summary of Benefits and Coverage here
Plan Guide here
Find a doctor here

Important Questions Answers Why this Matters:
What is the overall deductible?$0 Individual or
$0 Family
See the Common Medical Events chart below for your costs for services this plan covers.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible.
Are there services covered before you meet your deductible?Yes. Primary Care, Specialty Care, Lab and Xray services, some Prescription Drugs, Urgent Care, Outpatient Mental Health, Inpatient and Outpatient Hospital care, and Pediatric Dental and Vision are covered before the deductible.This plan covers some items and services even if you haven’t yet met the deductible amount. But a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost sharing and before you meet your deductible. See a list of covered preventive services at https://www.healthcare.gov/coverage/preventive-care-benefits/.
Are there other
deductibles for specific
services?
Yes, Prescription Drugs.
$4,950 Individual or
$9,900 Family
You must pay all of the costs for these services up to the specific deductible amount before this plan begins to pay for these services.
What is the out-of-pocket
limit for this plan?
$8,550 Individual or
$17,100 Family
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met.
What is not included in
the out-of-pocket limit?
Premiums, balance-billed charges, and health care this plan doesn’t cover.Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if you use a network provider? Yes. See
https://brighthealthplan.com/provider-finder/ifp or call 1-855-827-4448 for a list of network providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services.
Do you need a referral to
see a specialist?
YesThis plan will pay some or all of the costs to see a specialist for covered services but only if you have a referral before you see the specialist.
Common Medical EventServices You May Need

Your cost if you use
a Participating
Provider (You will pay the least)

Your cost if you use
a Non-Participating
Provider (You will pay the most)

Limitations & Exceptions, & Other Important Information
If you visit a health care provider’s office or clinicPrimary care visit to treat an injury or illness

 $50

Not covered

None
Specialist visit

$100

Not covered

None
Preventive care/screening/immunization

No charge

Not covered

You may have to pay for services that aren’t preventive. Ask your provider if the services needed are preventive. Then check what your plan will pay for.
If you have a testDiagnostic test (x-ray, blood work)

Labs $50 per visit X-ray $100 per visit

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
Imaging (CT / PET scans, MRIs)

$300

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
If you need drugs to treat
your illness or condition.
More information about
prescription drug coverage
is available at
www.brighthealthplan.com
Generic drugs (Tier 2)

$30

Not coveredTier 1 drugs are Preventive medications that are of $0 cost to you. Copays shown reflect the cost per retail prescription for a 30-day supply. Mail Order copays are 2.5 times the Retail cost for a 90-day supply
Preferred brand drugs (Tier 3)

$200

Not covered
Non-preferred brand drugs
(Tier 4)

50%

Not covered

Specialty drugs (Tier5)

50%

Not covered

If you have outpatient
surgery
Facility fee (e.g., ambulatory surgery center)

$1,000

Not covered

Services require pre-authorization.
Physician/surgeon fees

$300

Not covered

If you need immediate
medical attention
Emergency room care

$1,000

$1,000

None
Emergency medical transportation

50%

50%

None
Urgent care

$50

$50

None
If you have a hospital
stay
Facility fee (e.g., hospital room)

$2,500 per day

Not covered

Copay applies to first 2 days of hospitalization. Services require pre-authorization.
Physician/surgeon fee

$300

Not covered

If you have mental
health, behavioral
health, or substance
abuse needs
Outpatient services$50

Not covered

None
Inpatient services

$2,500

Not covered

Copay applies to first 2 days of hospitalization. Services require pre-authorization.
If you are pregnantOffice visits

No charge

Not covered

Copay applies to first 2 days of hospitalization. Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
Childbirth/delivery professional services

No charge

Not covered

Copay applies to first 2 days of hospitalization. Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.

Childbirth/delivery facility services

$2,500 per day

Not covered

Copay applies to first 2 days of hospitalization. Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.

If you need help
recovering or have other special health needs
Home health care

50%

Not covered

Services require pre-authorization

 

 

 

 

Copay applies per day up to 2 days. Services require pre-authorization. .

Rehabilitation services

$100

Not covered

Habilitation services

$100

Not covered

Skilled nursing care

$2,500 per day

Not covered

Durable medical equipment

50%

Not covered

Services require pre-authorization.
Hospice service50%

Not covered

Services require pre-authorization.
If your child needs
dental or eye care
Children’s eye exam

No Charge

Not covered

Limited to 1 eye exam per calendar year through the end of the month in which the dependent child turns19.
Children’s glasses

No Charge

Not covered

Limited to 1 pair of glasses including standard frames and standard lenses, or a one-year supply of contact lenses through the end of the month in which the dependent child turns 19.
Children’s dental check-up

Not Covered

Not Covered

Includes diagnostic and preventive services for dependent children through the end of the month in which the dependent child turns 19. Refer to the policy for covered services and limitations.

Excluded Services & Other Covered Services:

Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)
  • Acupuncture
  • Cosmetic Surgery
  • Dental care (Adults)
  • Long-term care
  • Non-emergency care when traveling outside the U.S.
  • Routine eye care (Adults)
  • Weight loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
  • Abortion care
  • Bariatric surgery
  • Chiropractic care
  • Hearing aids
  • Infertility treatment
  • Private-duty nursing
  • Routine foot care (for diabetes)

Bright Health Bronze 7000 HSA

Download Summary of Benefits and Coverage here
Plan Guide here
Find a doctor here

Important Questions Answers Why this Matters:
What is the overall deductible?$7,000 Individual or
$14,000 Family
See the Common Medical Events chart below for your costs for services this plan covers.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible.
Are there services covered before you meet your deductible?No. You will have to meet the deductible
before the plan pays for any services.
This plan covers some items and services even if you haven’t yet met the deductible amount. But a copayment or coinsurance may apply. For example, this plan covers certain preventive services without cost sharing and before you meet your deductible. See a list of covered preventive services at https://www.healthcare.gov/coverage/preventive-care-benefits/.
Are there other
deductibles for specific
services?
NoYou don’t have to meet deductibles for specific services.
What is the out-of-pocket
limit for this plan?
$7,000 Individual or
$14,000 Family
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met.
What is not included in
the out-of-pocket limit?
Premiums, balance-billed charges, and health care this plan doesn’t cover.Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if you use a network provider? Yes. See
https://brighthealthplan.com/provider-finder/ifp
or call 1-855-827-4448 for a list of network
providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services.
Do you need a referral to
see a specialist?
YesThis plan will pay some or all of the costs to see a specialist for covered services but only if you have a referral before you see the specialist.
Common Medical EventServices You May Need

Your cost if you use
a Participating
Provider (You will pay the least)

Your cost if you use
a Non-Participating
Provider (You will pay the most)

Limitations & Exceptions, & Other Important Information
If you visit a health care provider’s office or clinicPrimary care visit to treat an injury or illness

 0%

Not covered

None
Specialist visit

0%

Not covered

None
Preventive care/screening/immunization

No charge

Not covered

You may have to pay for services that aren’t preventive. Ask your provider if the services needed are preventive. Then check what your plan will pay for.
If you have a testDiagnostic test (x-ray, blood work)

0%

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
Imaging (CT / PET scans, MRIs)

0%

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
If you need drugs to treat
your illness or condition.
More information about
prescription drug coverage
is available at
www.brighthealthplan.com
Generic drugs (Tier 2)

0%

Not coveredTier 1 drugs are Preventive medications that are of $0 cost to you. Copays shown reflect the cost per retail prescription for a 30-day supply. Mail Order copays are 2.5 times the Retail cost for a 90-day supply
Preferred brand drugs (Tier 3)

0%

Not covered
Non-preferred brand drugs
(Tier 4)

0%

Not covered

Specialty drugs (Tier5)

0%

Not covered

If you have outpatient
surgery
Facility fee (e.g., ambulatory surgery center)

0%

Not covered

Services require pre-authorization.
Physician/surgeon fees

0%

Not covered

If you need immediate
medical attention
Emergency room care

0%

0%

None
Emergency medical transportation

0%

0%

None
Urgent care

0%

0%

None
If you have a hospital
stay
Facility fee (e.g., hospital room)

0%

Not covered

Services require pre-authorization.
Physician/surgeon fee

0%

Not covered

If you have mental
health, behavioral
health, or substance
abuse needs
Outpatient services0%

Not covered

None
Inpatient services

0%

Not covered

Preauthorization required
If you are pregnantOffice visits

0%

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
Childbirth/delivery professional services

0%

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
Childbirth/delivery facility services

0%

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
If you need help
recovering or have other special health needs
Home health care

0%

Not covered

Services require pre-authorization.
Rehabilitation services

0%

Not covered

Habilitation services

0%

Not covered

Skilled nursing care

0%

Not covered

Durable medical equipment

0%

Not covered

Services require pre-authorization.
Hospice service0%

Not covered

Services require pre-authorization.
If your child needs
dental or eye care
Children’s eye exam

No Charge

Not covered

Limited to 1 eye exam per calendar year through the end of the month in which the dependent child turns19.
Children’s glasses

No Charge

Not covered

Limited to 1 pair of glasses including standard frames and standard lenses, or a one-year supply of contact lenses through the end of the month in which the dependent child turns 19.
Children’s dental check-up

Not Covered

Not Covered

Includes diagnostic and preventive services for dependent children through the end of the month in which the dependent child turns 19. Refer to the policy for covered services and limitations.

Excluded Services & Other Covered Services:

Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)
  • Acupuncture
  • Cosmetic Surgery
  • Dental care (Adults)
  • Long-term care
  • Non-emergency care when traveling outside the U.S.
  • Routine eye care (Adults)
  • Weight loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
  • Abortion care
  • Bariatric surgery
  • Chiropractic care
  • Hearing aids
  • Infertility treatment
  • Private-duty nursing
  • Routine foot care (for diabetes)

Bright Health Bronze 8550

Download Summary of Benefits and Coverage here
Plan Guide here
Find a doctor here

Important Questions Answers Why this Matters:
What is the overall deductible?$8,550 Individual or
$17,100 Family
See the Common Medical Events chart below for your costs for services this plan covers.
Generally, you must pay all of the costs from providers up to the deductible amount before this plan begins to pay. If you have other family members on the plan, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible.
Are there services covered before you meet your deductible?Yes. Primary Care, Urgent Care and Generic Drugs are covered without a deductible.This plan covers some items and services even if you haven’t yet met the deductible amount.
But a copayment or coinsurance may apply. For example, this plan covers certain preventive
services without cost sharing and before you meet your deductible. See a list of covered
preventive services at https://www.healthcare.gov/coverage/preventive-care-benefits/.
Are there other
deductibles for specific
services?
NoYou don’t have to meet deductibles for specific services.
What is the out-of-pocket
limit for this plan?
$8,550 Individual or
$17,100 Family
The out-of-pocket limit is the most you could pay in a year for covered services. If you have other family members in this plan, they have to meet their own out-of-pocket limits until the overall family out-of-pocket limit has been met.
What is not included in
the out-of-pocket limit?
Premiums, balance-billed charges, and health care this plan doesn’t cover.Even though you pay these expenses, they don’t count toward the out-of-pocket limit.
Will you pay less if you use a network provider? Yes. See
https://brighthealthplan.com/provider-finder/ifp or call 1-855-827-4448 for a list of network providers.
This plan uses a provider network. You will pay less if you use a provider in the plan’s network. You will pay the most if you use an out-of-network provider, and you might receive a bill from a provider for the difference between the provider’s charge and what your plan pays (balance billing). Be aware your network provider might use an out-of-network provider for some services (such as lab work). Check with your provider before you get services.
Do you need a referral to
see a specialist?
YesThis plan will pay some or all of the costs to see a specialist for covered services but only if you have a referral before you see the specialist.
Common Medical EventServices You May Need

Your cost if you use
a Participating
Provider (You will pay the least)

Your cost if you use
a Non-Participating
Provider (You will pay the most)

Limitations & Exceptions, & Other Important Information
If you visit a health care provider’s office or clinicPrimary care visit to treat an injury or illness

$25 first 2 visits, then 0%

Not covered

$25 for the first 2 visits, then no charge after deductible
Specialist visit

0%

Not covered

None
Preventive care/screening/immunization

No charge

Not covered

You may have to pay for services that aren’t preventive. Ask your provider if the services needed are preventive. Then check what your plan will pay for.
If you have a testDiagnostic test (x-ray, blood work)

0%

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
Imaging (CT / PET scans, MRIs)

0%

Not covered

Pre-authorization is required for Imaging (CT/PET/MRI).
If you need drugs to treat
your illness or condition.
More information about
prescription drug coverage
is available at
www.brighthealthplan.com
Generic drugs (Tier 2)

$25

Not coveredTier 1 drugs are Preventive medications that are of $0 cost to you. Copays shown reflect the cost per retail prescription for a 30-day supply. Mail Order copays are 2.5 times the Retail cost for a 90-day supply
Preferred brand drugs (Tier 3)

0%

Not covered
Non-preferred brand drugs
(Tier 4)

0%

Not covered

Specialty drugs (Tier5)

0%

Not covered

If you have outpatient
surgery
Facility fee (e.g., ambulatory surgery center)

0%

Not covered

Services require pre-authorization.
Physician/surgeon fees

0%

Not covered

If you need immediate
medical attention
Emergency room care

0%

0%

None
Emergency medical transportation

0%

0%

None
Urgent care

0%

$50

None
If you have a hospital
stay
Facility fee (e.g., hospital room)

0%

Not covered

Services require pre-authorization.
Physician/surgeon fee

0%

Not covered

If you have mental
health, behavioral
health, or substance
abuse needs
Outpatient services0%

Not covered

None
Inpatient services

0%

Not covered

Preauthorization required
If you are pregnantOffice visits

No charge

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
Childbirth/delivery professional services

0%

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
Childbirth/delivery facility
services

0%

Not covered

Delivery stays exceeding 48 hours for vaginal delivery or 96 hours for a cesarean delivery require preauthorization.
If you need help
recovering or have other special health needs
Home health care

0%

Not covered

Services require pre-authorization.
Rehabilitation services

0%

Not covered

Habilitation services

0%

Not covered

Skilled nursing care

0%

Not covered

Durable medical equipment

0%

Not covered

Services require pre-authorization.
Hospice service0%

Not covered

Services require pre-authorization.
If your child needs
dental or eye care
Children’s eye exam

No Charge

Not covered

Limited to 1 eye exam per calendar year through the end of the month in which the dependent child turns19.
Children’s glasses

No Charge

Not covered

Limited to 1 pair of glasses including standard frames and standard lenses, or a one-year supply of contact lenses through the end of the month in which the dependent child turns 19.
Children’s dental check-up

Not Covered

Not Covered

Includes diagnostic and preventive services for dependent children through the end of the month in which the dependent child turns 19. Refer to the policy for covered services and limitations.

Excluded Services & Other Covered Services:

Services Your Plan Generally Does NOT Cover (Check your policy or plan document for more information and a list of any other excluded services.)
  • Acupuncture
  • Cosmetic Surgery
  • Dental care (Adults)
  • Long-term care
  • Non-emergency care when traveling outside the U.S.
  • Routine eye care (Adults)
  • Weight loss programs
Other Covered Services (Limitations may apply to these services. This isn’t a complete list. Please see your plan document.)
  • Abortion care
  • Bariatric surgery
  • Chiropractic care
  • Hearing aids
  • Infertility treatment
  • Private-duty nursing
  • Routine foot care (for diabetes)