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* Services must be rendered and billed by Kadlec Medical Center

Kadlec: 2013 Medical Plan Comparison . Kadlec is pleased to provide you with the option of two major medical plans administered by First Choice Administrators: The Basic HRA Plan or the Enhanced HRA Plan. * Services must be rendered and billed by Kadlec Medical Center

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* Services must be rendered and billed by Kadlec Medical Center

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  1. Kadlec: 2013 Medical Plan Comparison Kadlec is pleased to provide you with the option of two major medical plans administered by First Choice Administrators: The Basic HRA Plan or the Enhanced HRA Plan. * Services must be rendered and billed by Kadlec Medical Center ** Emergency room coinsurance is 80% at KMC, In-Network, and Out-of-Network Once you have paid your bridge and coinsurance maximum, the plan will pay 100% of medical expenses for the remainder of the year. This DOES NOT include charges that exceed the plan’s usual & customary limits, services that exceed plan limitations, or vision and pharmacy costs.

  2. Prescription Benefits For your convenience, you can choose to obtain a 90-day supply of your maintenance prescriptions either through the Mail Order Program or at Participating Choice 90 Pharmacies (excludes Walgreens and CVS pharmacies). You can go to www.myFirstChoice.fchn.com to view a list of participating Choice 90 and mail order pharmacies. Please note: Certain drugs may require preauthorization, step therapy, or have dispensing limitations. Specialty injectable prescriptions may need to be purchased from a specific provider. This plan encourages the use of generic drugs whenever available. If you choose a brand-name drug instead of a generic equivalent, you will be required to pay the cost difference between the generic and the brand-name drug. Vision Benefits We are offering you a vision benefit through First Choice Administrators. A routine eye exam is important, not only for correcting vision, but because it can lead to detecting other serious health conditions. The plan also includes coverage for vision hardware, either eyeglasses or contact lenses. Please note that the vision hardware plan may not cover all costs including lens coatings, contact lens fitting and taxes. If you choose to use an out-of-network provider, you will have to pay your provider at the time of service and you may be required to submit your own claim to the insurance company.

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