Teammate Open Enrollment 2021
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Medicare Plans
PERS Select
PERS Choice
PERSCare
CAHP Medicare Supplement (Association Plan)
PORAC (Association Plan)
PPO
Non-PPO
PPO
Non-PPO
PPO
Non-PPO
BENEFITS
Emergency Services (waived if admitted or hospitalized as an outpatient) No Charge No Charge
No Charge
No Charge
No Charge
Ambulance Services
No Charge
No Charge
No Charge
No Charge
No Charge
Surgery/Anesthesia
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 No Charge No Charge
$10
No Charge No Charge No Charge No Charge No Charge
Inpatient Visits Outpatient Visits Urgent Care Visits Preventive Services
No Charge No Charge No Charge No Charge
No Charge No Charge No Charge No Charge
No Charge No Charge No Charge No Charge
Diagnostic X-Ray/Lab
No Charge
No Charge
No Charge
No Charge
No Charge
Durable Medical Equipment
No Charge
No Charge
No Charge
No Charge
No Charge
2021 Health Benefit Summary | 27
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