Historical Newspapers of South Carolina

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...page 10 SUMMAR Medical I The benefits shown in this Sumrr your eligible dependents. The accident and health benefits d certain benefits for which the Em| liable for such benefits to the es Employer. The Insurance Compai ments. ELI You are in on Eligible Class if you Participating Employer whose regu hours. Your Eligibility Date, if you are in the Plan if you are then working first Monday following the date yo for your Employer. MEDICAL EX FOR YOU AND Youi Booklet Certificate spells ot applies BASIC MEDICAL HOSPITAL BENEFITS Deductible Board and Room Daily Maximum Board and Room Total Maximum. Additional Inpatient Maximum Maximum Number of Days 3urnjiv,?L DC IN c r I ID Maximum . . . . Note The Schedule of Procedu find ?he maximum bene fot Surgical Services, mu procedure in the Schedule ANESTHESIA BENEFIT Maximum PHYSICIANS BENEF ITS (In hosp Per Day Maximum Total Maximum Maximum Period of Payment. . AMBULANCE BENEFITS Per Disability Maximum DIAGNOSTIC LABORATORY Alv BENEFITS X RAY AND RADIOACTIVE THE f^uurall Mavimum Note The Schedule of Treatmei Per Day and Per Calend; mined from the Schedule fied for the applicable trej SUPPLEMENTARY ACCIDENT B Maximum CHEMOTHERAPY BENEFITS Per Day Maximum Total Maximum M AJL cxpen: Deductible Family Deductible Limit Coinsurance (Out of Pocket) Limi Family Ccmsurance (Out of Pocki Maximum Convalescent Period Home Health Care Maximum Visil Private Room Limit Hospital . Other Instrtut ons Lifetime Maximum Benefit 'Deductible and Coinsurance (Out PREGNAN Med'caj Expanse Benefits are pa^ female employees anil dependents o not the pregnancy commences wh'li Normally tne expenses must be under this Pian However, if expens they will be considered for benefil ?Etna that the individual has beer minated Prior Pians any pregnancy benefi eraqe will be subtracted frorri medii under this Plan Y OF COVERAGE Expense Coverage lary of Coverage are available for you and lescribed in the Booklet are integrated with plover is liable. The Insurance Company is tent that they are not the liability of the ny, however, will process all benefit pay GIBILITY are a permanent full-time employee of a larly scheduled work week is at least 24 an Eligible Class, is the Effective Date of I for your Employer, otherwise it is the u complete 1 month of continuous service PENSE COVERAGE YOUR DEPENDENTS Jt the period to which each maximum EXPENSE COVERAGE S93 S93 S6510 SI.200 70 SI.600 it's appears in the Booklet Certificate To fit payable for any particular procedure Itiply the number of units listed for that by S3 S320 ital) S3 S560 70 days C 1 on ID X RAY See Booklet-Certificate IRAPY BENEFITS S500 nts appears in the Booklet Certificate. The ir Year maximum amounts can be deter bv multiplying the number o' units spec* itments by $10.00 ENETITS S300 S20 S500 )R MtDICAL 5E COVERAGE SI 50* S450 i S850* st> Limit S850* The first 120 days of convalescent facility confinement, is 120 The institution's semipr ivate riite, p'us S6 The institution's semipnvate rate S200.000 of Pocke') Limit S1.00C CY COVERAGE /able for pregnancy-related expenses of n the same basis as for disease, whether <v t the individual is covered under 'his Piari incurred while the individual is covered ;es are incurred after the coverage ceases. Is if satisfactory evidence is furnisher) to i totally disabled since her coverage ter ts payable by previous group medical cov :al benefits payable for the same expenses Is it alright to questio about his It certainly is. Hon< to be sure you have services that pu ac have been billed inc physician will be gl be sure you have cc completely and acci the processing of y< Medical Costs: \ What can we as employees of Clinton Mill 1. Talk frankly to your doctor about his fee. ask him why. Concerned doctors will gladly v only "reasonable and customary" charges. T questions you have about Group Insurance c 2. Use but don't abuse your insurance. Use ask for "a day or so longer" in the hospital, do dation, or visit his office unnecessarily. 3. Look over your medical care bill. Did you the charges "reasonable and customary" as p yuur uuuiur. 4. Establish a home and auto safety progra result of off-the-job accidents. It hurts to ge ADDITIONAL I A change has been made jn your Maior V youi BookletCertificate The following si Limitations'" is substituted for the same Booklet Certificate ARE THERE ANY LIMITATIONS? Yes. The following limitations apply: Dental Work. Oral Surgery, and Cosmetic Expenses for uental work and oral su Medical Expenses if they are for the pi body tissue required as a result of an dividual is covered undei this Plan. Thi ur iMiiuiieu ?e> v^oveieo ivieuicdi txpen 1 The excision of teeth not completel 2 The excision of a tooth root withi hut not including root Cdiidl therap' 3 Other incision or excision procedu mouth when not performed in cunt t.on, hut not including Oentdl cledi scraping procedures For the purposes of the dental work an the term "physician" includes a duly I ice Cosmetic surgery expenses may he inclur only for the prompt repair of an injury c covered under this Plan n the doctor bill? est errors occur, so check i been billed only for tually received. If you :orrectly, the hospital or lad to correct the error. And tmpleted your claim form [irately. This will speed up _ 1 _ )ur ciaim. Vhat Can We Do? s do to hold down medical costs? If his fee is substantially higher than area tees, velcome your questions. Our insurance covers he Personnel Office will be pleased to discuss :overage. it when your doctor so recommends but do not not demand medication against his recommenreceive all the supplies and services listed? Are rovided in our policy? Discuss the charges with m. Some of the most expensive claims are the it hurt ? physically and financially. :hanses ledical Expense Coverage section of ibsection entitled "Are There Any subsection now appearing in your Surgery rgery may be included as Covered ompt repair of natural teeth or other iri|ury which occurs while the in ? only other such expenses that may ses are tor the following ly erupted >ut extraction of the entire tooth, res on the gums and tissues of the icction with tootfi repair or extrac ling, mot scaling, planing or other d oral su gery recoqni/ed above. >nsed dentist. fed as Covered Medical Expenses iccurnng while the individual is