Please use the below form to search for Benefit cost by plan. If you have any questions, please contact one of our friendly representatives by calling 1-844-891-2121 (TTY 711).
Financial obligations may vary between in-network and out-of-network benefits, and members could be liable for costs exceeding approved amounts. The benefits listed on this page provide an overview of what we cover and what you pay. It does not list every service, limitation, restriction, or exclusion. For a complete list of services and to verify benefit information, please refer to the plan’s Evidence of Coverage (EOC) under Plan Documents.