BENEFIT HIGHLIGHTS
IN-NETWORK
OUT-OF-NETWORK
Substance Use Disorder Inpatient
80% after plan deductible
50% of the Maximum Reimbursable Charge after plan deductible
Includes Acute Inpatient Detoxification, Acute Inpatient Rehabilitation and Residential Treatment Calendar Year Maximum: Unlimited Outpatient Outpatient - Office Visits Includes individual, family and group psychotherapy; medication management, virtual care, etc. Calendar Year Maximum: Unlimited Dedicated Virtual Providers MDLIVE Behavioral Services Outpatient - All Other Services Includes Outpatient Detoxification, Partial Hospitalization, Intensive Outpatient Services, virtual care, etc. Calendar Year Maximum: Unlimited
80% after plan deductible
50% of the Maximum Reimbursable Charge after plan deductible
80% after plan deductible
In-Network coverage only
80% after plan deductible
50% of the Maximum Reimbursable Charge after plan deductible
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