Benefits
Prosthetic & Orthopedic Device & Durable Medical Equipment
Prosthetic & OrthopedicPPO: $50 per device co-payment
Non-PPO: 50% UCR after deductible
Durable Medical Equipment
PPO: $50 per device co-payment
Non-PPO: 50% UCR after deductible
Medical Supplies
PPO: No co-payment
Non-PPO: 50% UCR after deductible