Transcription of Summary of Benefits
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Summary of Benefits
Summary of Benefits Blue Cross medicare Advantage Flex (PPO)SM January 1, 2022 December 31, 2022 This booklet gives you a Summary of what we cover and what you pay. It doesn t list every service that we cover or list every limitation or exclusion. To get a complete list of services we cover, call us and ask for the "Evidence of Coverage." Y0096_8634014SB22_M Pre-Enrollment Checklist Before making an enrollment decision, it is important that you fully understand our Benefits and rules. If you have any questions, you can call and speak to a customer service representative at 1-877-774-8592 (TTY/TDD: 711). We are open from 8:00 8:00 , local time, 7 days a week.
Eyeglasses or contact lenses after cataract surgery In-network: 0% of the total cost for 1 pair of Medicare-covered eyeglasses (lenses and frames) or contact lenses after cataract surgery Out-of-Network: 0% of the total cost for 1 pair of Medicare-covered eyeglasses (lenses and frames) or contact lenses after cataract surgery
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