2013 Employee Benefits Guidebook - Administration Home
2013 Employee Benefits Guidebook - Administration Home
2013 Employee Benefits Guidebook - Administration Home
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Note: The copayment will apply as long as services billed include one or more of the facility room charges:<br />
Operating room, recovery room, procedures room, treatment room, and observation room.<br />
Skilled Nursing Facility, Rehabilitation<br />
Hospital and<br />
Sub-Acute Facilities<br />
75% after deductible the facility's<br />
semiprivate room rate<br />
Not Covered<br />
Emergency Room Services<br />
(including ER Physician services)<br />
100% after $200 copayment per visit;<br />
No deductible applies<br />
Medical Non-Emergency Care<br />
Not Covered<br />
Note: The ER copayment will be waived if admitted to the Hospital directly from the ER.<br />
Urgent Care Services<br />
100% after $100 copayment per<br />
Not Covered<br />
visit;<br />
No deductible applies<br />
Note: The Urgent Care copayment will be waived if admitted to the Hospital directly from Urgent Care.<br />
Physician Services<br />
Inpatient Services 75% after deductible Not Covered<br />
El Paso County <strong>Employee</strong> Health Center 100% after $10 copayment per<br />
Not Covered<br />
(Clinic) Office Visit<br />
visit<br />
Primary Care Physician (PCP)<br />
Office Visit<br />
No deductible applies<br />
100% after $50 copayment per<br />
visit<br />
No deductible applies<br />
Not Covered<br />
Note: A Primary Care Physician (PCP) is defined as a general practitioner, family practitioner, general internist<br />
(internist whose practice is 70% general medicine), Nurse Practitioner, Physician’s Assistant, or pediatrician.<br />
An OB/GYN will be considered a specialist.<br />
Specialist office visits<br />
Surgery performed in the office (including<br />
any medical supplies and injections<br />
rendered during the surgery)<br />
100% after $75 copayment per<br />
visit<br />
No deductible applies<br />
100% after $10 Clinic, $50 PCP<br />
or<br />
$75 Specialist copayment per visit<br />
Not Covered<br />
Not Covered<br />
No deductible applies<br />
Injections (other than allergy or<br />
100%<br />
chemotherapy)<br />
No deductible or copayment will<br />
apply<br />
Allergy serum and injections 100%<br />
No deductible or copayment will<br />
apply<br />
Preventive Care*<br />
Routine Well Care<br />
(ages birth through adult)<br />
100%<br />
No deductible or copayment<br />
applies<br />
Not Covered<br />
Not Covered<br />
Not Covered<br />
<strong>2013</strong> <strong>Employee</strong> Benefit <strong>Guidebook</strong><br />
Updated August <strong>2013</strong>