Effective August 1, 2009, the Rotavirus and the Human Papillomavirus (HPV) vaccines are now covered under the Plan.
Coverage is based on the normal coverage guidelines for immunizations, which are:
• Under Plan A, the Plan will pay up to 100% of the Allowed Amount for up to five immunizations by an in-network provider, per calendar year, before the child turns 18 years old.
• For immunizations by an out-of-network provider, Plan A will pay up to 50% of the Allowed Amount for up to three immunizations during a child’s first year.
Please remember, immunizations are not covered for any child after their eighteenth birthday. For immunizations that are not covered under the Plan, you should contact your local county’s Board of Health. A Board of Health will often provide the same vaccines that you would receive at your physician’s office, but at a much lower out-of-pocket cost to you.
Effective August 1, 2009, the outpatient medical care allowance for specified SuperMed Plus Network PPO in-network services will be raised from 90% of the allowed amount to 95% of the allowed amount. This will apply to hospital outpatient charges for lab, x-ray and minor surgery; hospital outpatient charges for diagnostic x-ray and lab that are illness-related; and general outpatient x-ray and lab charges.
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