Commonwealth Care Type I

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Covered Benefit Co-Payment
Outpatient Medical Care
Community Health Center Visits (Primary Care and Specialist) $0
Office Visits (PCP/Specialists) $0
Outpatient Surgery (Hospital and Ambulatory Surgery Centers) $0
Abortion Services $0
X-rays/Labs $0
Inpatient Medical and Maternity Care $0
Prescription Drugs
Medication via Pharmacy (1 month supply)
*Generics for treatment of high blood pressure, high cholesterol, and diabetes
Generic* $1
Generic $2
Brand $3
Emergency Care $0
Inpatient Mental Health & Substance Abuse $0
Outpatient Mental Health & Substance Abuse $0
Methadone Treatment (dosing, counseling, labs) $0
Rehabilitation Services
Cardiac Rehabilitation $0
Home Health Care $0
Inpatient Rehabilitation Services
(combined 100 days per Contract Year)
Skilled Nursing Facility $0
Inpatient Rehabilitation or Chronic Disease Hospital $0
Short-term outpatient rehabilitation
(Physical, Occupational, and Speech Therapies)
$0
Other Benefits
Ambulance (emergency only) $0
Dental
(restorative, preventative, radiography, diagnostic, prosthodontic, and oral surgery)
$0
Durable Medical Equipment, Supplies, Prosthetics, Oxygen & Respiratory Therapy Equipment $0
Hospice $0
Orthotics $0
Routine foot care (for diabetics) $0
Vision (exam and glasses every 24 months) $0
Wellness
(Family Planning, Nutritional Counseling, Prenatal, Nurse Midwife)
$0
Annual Out-of-Pocket Expenses per benefit year Maximum amount
Pharmacy $200