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myBenefits at a Glance

The highlights below are provided as general information. Coverage for eligible costs is based on the contract detail. Select the benefit for additional coverage details.

Reimbursed at 80% to a maximum of $250 per occurrence.

Prescription Drugs:
Reimbursed at 70% to a maximum of $3,000 per benefit year.
Based on the National Drug Formulary with a generic rider.

Reimbursed at 100%, combined maximum of $100 for one eye exam, glasses or contact lenses every 24 months.

Health Practitioners:
The services of paramedical practitioners are reimbursed at 80% to a maximum of $20 per visit. Each service has an overall plan maximum of $300 per benefit year.

Medical Equipment & Supplies:
Reimbursed at 80%. A physician's prescription is required. Pre-authorization is suggested.

Dental Accident:
Reimbursed at 80% of eligible expenses to a maximum of $1,000 per accident,
services must be performed within 12 months of the accident.

Dental Coverage:
Exams covered at 70% once per benefit year. Overall plan maximum of $750 per benefit year.

Accidental Death & Dismemberment:
$5,000 loss of life benefit.

After 15 days of confinement due to illness or injury.

NOTE: In the event of any discrepancy between the information herein and our contract with the insurer, the terms of the contract will apply.

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