Network Type- PPO Nationwide
 
Summary of Coverages
 
 
 
 
 
 
 
 
 
 
Diseases/Sicknesses
Doctor Office Visit
Prescription Drugs
X-Ray
Labs
Spinal Manipulation Office Visit
Emergency Room
Emergency Air/Ground Ambulance
Specialty Radiology
CAT Scan
PET Scan
MRI
Radiation Therapy
Oral Chemotherapy
IV Chemotherapy
Urgent Care Facility
Diabetes Equipment, Supplies & Training
Outpatient Medical Foods
Outpatient Surgeon Benefit
Surgery Facility
Kidney Dialysis
Hospital Room & Board
ICU Room & Board
Hospital Miscellaneous Expenses
Increased Critical Hospital Miscellaneous
Expenses for Specified 
 
Major Diseases/Sicknesses
Inpatient Surgeon Benefit
Coronary Artery By-pass
Coma
Heart Attack
Life Threatening Cancer
Stroke
Outpatient Surgeon Benefit 
 
Accidents
Doctor Office Visit
Prescription Drugs
X-Ray
Labs
Spinal Manipulation Office Visit
Emergency Room
Emergency Air/Ground Ambulance
Specialty Radiology
CAT Scan
MRI
Urgent Care Facility
Outpatient Surgeon Benefit
Surgery Facility
 
Hospital Confinement Daily Benefits
Hospital Room & Board
ICU Room & Board
Hospital Miscellaneous Expenses
Increased Critical Hospital Miscellaneous
Expenses for Bodily Injury:
Coma
Severe Burn
     
Bodily Injury
Fractures
Cuts & Punctures
Back Injuries
Burns
Sports Injuries
Head Injuries
Bone Injuries
Knee Injuries
Ligament & Tendon Injuries
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