Teammate Handbook Cover
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Medicare Plans
CCPOA Medical Plan Medicare (PPO)
Western Health Advantage MyCare Select (HMO)
UnitedHealthcare Group Medicare Advantage Edge (PPO)
PERS Gold
PERS Platinum
CAHP Medicare Supplement (Association Plan)
PORAC (Association Plan)
PPO Non PPO
PPO Non PPO
BENEFITS
Hearing Services
Routine Hearing Exam
No Charge No Charge
No Charge No Charge
No Charge
No Charge No Charge
No Charge No Charge
No Charge No Charge 10% ($1,000 max/ 36 months)
20% 20%
Physician Services
$10
$2,000 allowance every 24 months
20% ($1,000 max/36 months)
20% ($2,000 max/24 months)
20% ($900 max/ 36 months)
$1,000 max/ 36 months
$500 max/ 12 months
Hearing Aids
Vision Care
Vision Exam
One exam per calendar year
One exam per calendar year
N/A
20%
No Charge
No Charge
$10
Eyeglasses
One set of frames during a 24-month period; $30 maximum allowance
One set of frames during a 24-month period; $30 maximum allowance
20% ($40 maximum allowance)
No Charge
No Charge
No Charge
N/A
Contact Lenses
20% ($40 maximum allowance)
$100 maximum allowance
$100 maximum allowance
No Charge
No Charge
No Charge
No Charge
Benefits Beyond Medicare (Services covered beyond Medicare coverage)
Acupuncture
$15/visit (acupuncture/ chiropractic; combined 20 visits per calendar year) $15/visit (acupuncture/ chiropractic; combined 20 visits per calendar year)
$15/visit (acupuncture/ chiropractic; combined 20 visits per calendar year) $15/visit (acupuncture/ chiropractic; combined 20 visits per calendar year)
$15/visit (acupuncture/ chiropractic;
$15/visit (acupuncture/ chiropractic;
$15/visit (acupuncture/ chiropractic;
20%
20%
combined 20 visits per calendar year)
combined 20 visits per calendar year)
combined 20 visits per calendar year)
Chiropractic
$15/visit (acupuncture/ chiropractic;
$15/visit (acupuncture/ chiropractic;
$15/visit (acupuncture/ chiropractic;
20%
20%
combined 20 visits per calendar year)
combined 20 visits per calendar year)
combined 20 visits per calendar year)
2023 Health Benefit Summary | 31
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