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Health & Welfare -  Medical Benefits

Medical coverage is one type of benefit provided by your health & welfare coverage.   The Plan has preferred providers for certain medical procedures and treatments, please review Using a Preferred Provider for details, as out-of-network penalties are applied to your payment when you do not use a preferred provider when one is available.   There are no preferred provider physicians, you may use the physician of your choice without an out-of-network penalty.
 

What's Covered

Most types of medical services are covered by the Plan; however, all procedures or treatments must be medically  necessary to be covered.  Some procedures need to be Pre-authorized to be covered.   The Plan offers a Wellness and Minor Care Program for routine, minor care, and preventative care for adults and children over the age of 2.

See the Summary of Benefits for Plans 551 - 554, or Plan 500  for an overview of covered services.   For details please review the Summary Plan Documents or your Plan Booklet. 

Once deductibles have been met, payment will equal the reimbursement rate multiplied by the covered charge (generally the actual charge or the usual and customary charge for that service, whichever is lower). 

Effective January 1, 2015: A new hearing aid benefit was added to medical plans 500, 552, 553, and 554. The Plan now pays up to $500 in a three year period towards the cost of hearing aids. The reimbursement will be at the regular plan percentage, after your annual deductible has been met.

The information contained on this website is intended to be a summary only.  In case of a difference, actual Plan Provisions will apply.  Always refer to your Plan Booklet for details.

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