use disorder outpatient services / retail / treatment of sexual dysfunction / source brand name contraceptive drugs/devices / health outpatient services / state insurance department / medical transportation / inpatient services / implantable hearing devices / room services / reproductive and genetic services / excluded services / covered services / /
MedicalCondition
In-network Provider Substance use disorder / Substance use disorder / injury / illness / MS / infertility / diabetes / limit Autism spectrum disorders / cataract / /
MedicalTreatment
immunization / chiropractic / surgical treatment / surgery / investigational treatments / Physical therapy / Cosmetic surgery / occupational therapy / Home infusion therapy / vaccinations / speech therapy / cataract surgery / Bariatric surgery / /
Organization
U.S. Department of Health and Human Services / Employee Benefits Security Administration / Formulary Brand Mesa Benefits Administration / FSA / U.S. Department of Labor / / /
Choice Summary of Benefits and Coverage: What this Plan Covers & What it Costs Coverage Period: [removed]2014 Coverage for: Individual | Plan Type: PPO