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Medicare Plans
Western Health Advantage MyCare Select (HMO)
CCPOA Medical Plan Medicare (PPO)
PERS Gold
PERS Platinum
CAHPMedicare Supplement (Association Plan)
PORAC (Association Plan)
PPO Non-PPO PPO Non-PPO
BENEFITS
Surgery/Anesthesia
No Charge
No Charge
No Charge
No Charge
No Charge
No Charge
Physician Services (including Mental Health and Substance Abuse)
Office Visits
No Charge No Charge No Charge No Charge No Charge
$10
No Charge No Charge No Charge No Charge No Charge
No Charge No Charge No Charge No Charge No Charge
$10
No Charge No Charge No Charge No Charge No Charge
Inpatient Visits Outpatient Visits Urgent Care Visits Preventive Services Diagnostic X-Ray/Lab
No Charge
No Charge No Charge No Charge No Charge
$10
No Charge No Charge
No Charge
No Charge
No Charge
No Charge
No Charge
No Charge
Durable Medical Equipment
No Charge
No Charge
No Charge
No Charge
No Charge
No Charge
2024 Health Benefit Summary | 27
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