Anthem CDHP - ES Represented Baltimore

100% covered; not deducted from HRA account;subject to Reasonable and Customary limits; mustmeet preventive guidelines; check with Plan for detailsAllergy tests and treatmentsFertility servicesIn vitro fertilizationArtificial inseminationFemale tubal ligationMale vasectomyOffice visit: Pre/postnatalIn Network90% covered after deductible is metOut of Network60% covered after deductible is met; subject toReasonable and Customary limitsIn Network90% covered after deductible is met; limited to$25,000 per lifetime including prescription drugs; inand out-of-network combinedOut of Network60% covered after deductible is met; limited to$25,000 per lifetime including prescription drugs; inand out-of-network combined; subject to R&C limitsIn Network90% covered after deductible is met; limited to$25,000 per lifetime for all fertility services combinedincluding prescription drugs; in and out-of-networkcombinedOut of Network60% covered after ded is met; limited to $25,000 perlifetime for all fertility services combined includingprescription drugs; in and out-of-network combined;subject to R&C limitsIn Network90% covered after deductible is met; limited to$25,000 per lifetime for all fertility services combinedincluding prescription drugs; in and out-of-networkcombinedOut of Network60% covered after deductible is met; limited to$25,000 per lifetime for all fertility services combinedincluding prescription drugs; in and out-of-networkcombined; subject to R&C limitsIn Network90% covered after deductible is metOut of Network60% covered after deductible is met; subject toReasonable and Customary limitsIn Network90% covered after deductible is metOut of Network60% covered after deductible is met; subject toReasonable and Customary limitsIn Network90% covered after deductible is metOut of Network60% covered after deductible is met; subject toReasonable and Customary limits