Find a 2025 BayCarePlus^® (HMO) Plan in Your Area

All of the BayCarePlus (HMO) plans bundle your hospital, medical and prescription drug benefits into one plan and include money-saving extra benefits like dental and vision coverage and free health club memberships. Below is an overview of each 2025 plan so that you may quickly and easily compare your options.

Medicare Plans to Fit Your Needs

BayCarePlus offers several plan options so you can choose the plan that best meets your personal needs. All plans include medical and hospital coverage as well as prescription drugs, dental, vision, hearing and fitness benefits, plus more. View our plan comparison below to see highlights and request an Enrollment Guide to see a Summary of Benefits.

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Benefit	BayCarePlus Rewards (HMO) H2235-002	BayCarePlus Complete (HMO) H2235-001	BayCarePlus Premier (HMO) H2235-003
Medical and Hospital
Monthly Premium	$0	$0	$49 You may be able to lower your premium, if you get Extra Help from Medicare
Part B Premium Monthly Saving	$134 per month	Not Covered	Not Covered
Maximum Out-Of-Pocket Limit	$3,900 per calendar year	$2,000 per calendar year	$2,900 per calendar year
Annual Deductible	$0	$0	$0
Primary Care Physician Visits	$0 copay	$0 copay	$0 copay
Specialist Visits	$25 copay	$10 copay	$25 copay
Inpatient Hospital Care	$200 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond	$150 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond	$175 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond
Urgent Care	$20 copay	$20 copay	$20 copay
Emergency Care	$125 copay	$125 copay	$125 copay
Lab Services	$0 copay	$0 copay	$0 copay
Part D Prescription Drug Coverage
Annual Deductible	$0	$0	$0
Tier 1 Preferred Generic	$0 copay	$0 copay	$0 copay
Tier 2 Generic	$10 copay	$3 copay	$0 copay
Tier 3 Preferred Brand	$47 copay	$35 copay	$30 copay
Tier 4 Non-Preferred Brand	40% coinsurance	31% coinsurance	31% coinsurance
Tier 5 Specialty Drug	33% coinsurance	33% coinsurance	33% coinsurance
Tier 6 – Select Maintenance Drug	$0 copay	$0 copay	$0 copay
Tier 1-4 Mail Order (up to a 100 Day Supply)	$0 / $0 / $125 / 40%	$0 / $0 / $95 / 31%	$0 / $0 / $80 / 31%
Tier 6 Mail Order (up to a 100 Day Supply)	$0 copay	$0 copay	$0 copay
Diabetic Insulin (One Month Supply)	Tier 1 - N/A Tier 2 - $10 copay Tier 3 - $35 copay Tier 4 - $35 copay Tier 5 - N/A	Tier 1 - N/A Tier 2 - $3 copay Tier 3 - $35 copay Tier 4 - $35 copay Tier 5 - N/A	Tier 1 - N/A Tier 2 - $0 copay Tier 3 - $30 copay Tier 4 - $35 copay Tier 5 - N/A
Initial Coverage Limit	$2,000
View the drugs covered by this plan
Extra Benefit Highlights
Dental (Base Option)	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $2,000 for comprehensive dental.	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $3,000 for comprehensive dental.
Optional Comprehensive Dental*	Monthly Premium: $50.20 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental	Monthly Premium: $49.60 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental
Vision	$0 copay for routine eye exam $0 copay or a pair of eyeglasses (lenses and frames) or contacts $150 max benefit (non-Medicare-covered eyewear) per calendar year	$0 copay for routine eye exam $0 copay for a pair of eyeglasses (lenses and frames) or contacts $300 max benefit (non-Medicare-covered eyewear) per calendar year for eyeglass (lenses and frames) or $350 max benefit per year for contacts
Hearing Aids (Up to two hearing aids every calendar year [one per ear])	$599 or $899 copay per hearing aid	$699 or $999 copay per hearing aid	$599 or $899 copay per hearing aid
Over-the-Counter (OTC) Items	Not covered	$140 per quarter	$175 per quarter
Transportation Assistance	Not covered	$0 copay for 16 one-way trips to approved locations per calendar year	$0 copay for 24 one-way trips to approved locations per calendar year
Meals	Not covered	56 home-delivered, post-discharge meals per calendar year
Travel Benefits	Emergency or urgent care coverage if you’re making a trip out of state or country.
Important Documents (All Plans)	Provider Directory Drug Formulary Star Ratings Formulary Change Notice Summary of Benefits
Documentos Importantes (Todos los planes)	Directorio d Proveedores Formulario de Medicamentos Recetados Calificaciones por Estrellas Resumen de Beneficios (Disponible próximamente)
Important Documents (Plan Specific)	Evidence of Coverage Annual Notice of Change	Evidence of Coverage Annual Notice of Change	Evidence of Coverage Annual Notice of Change
Documentos Importantes (Específico del Plan)	Evidencial de Cobertura Aviso Anual de Cambio	Evidencial de Cobertura Aviso Anual de Cambio	Evidencial de Cobertura Aviso Anual de Cambio

Medical and Hospital

Benefit	BayCarePlus Rewards (HMO) H2235-002
Monthly Premium	$0
Part B Premium Monthly Saving	$134 per month
Maximum Out-Of-Pocket Limit	$3,900 per calendar year
Annual Deductible	$0
Primary Care Physician Visits	$0 copay
Specialist Visits	$25 copay
Inpatient Hospital Care	$200 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond
Urgent Care	$20 copay
Emergency Care	$125 copay
Lab Services	$0 copay

Benefit	BayCarePlus Complete (HMO) H2235-001
Monthly Premium	$0
Part B Premium Monthly Saving	Not Covered
Maximum Out-Of-Pocket Limit	$2,000 per calendar year
Annual Deductible	$0
Primary Care Physician Visits	$0 copay
Specialist Visits	$10 copay
Inpatient Hospital Care	$150 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond
Urgent Care	$20 copay
Emergency Care	$125 copay
Lab Services	$0 copay

Benefit	BayCarePlus Premier (HMO) H2235-003
Monthly Premium	$49 You may be able to lower your premium, if you get Extra Help from Medicare
Part B Premium Monthly Saving	Not Covered
Maximum Out-Of-Pocket Limit	$2,900 per calendar year
Annual Deductible	$0
Primary Care Physician Visits	$0 copay
Specialist Visits	$25 copay
Inpatient Hospital Care	$175 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond
Urgent Care	$20 copay
Emergency Care	$125 copay
Lab Services	$0 copay

Monthly Premium	$49 You may be able to lower your premium, if you get Extra Help from Medicare
Part B Premium Monthly Saving	Not Covered
Maximum Out-Of-Pocket Limit	$2,900 per calendar year
Annual Deductible	$0
Primary Care Physician Visits	$0 copay
Specialist Visits	$25 copay
Inpatient Hospital Care	$175 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond
Urgent Care	$20 copay
Emergency Care	$125 copay
Lab Services	$0 copay

Monthly Premium	$49 You may be able to lower your premium, if you get Extra Help from Medicare
Part B Premium Monthly Saving	Not Covered
Maximum Out-Of-Pocket Limit	$2,900 per calendar year
Annual Deductible	$0
Primary Care Physician Visits	$0 copay
Specialist Visits	$25 copay
Inpatient Hospital Care	$175 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond
Urgent Care	$20 copay
Emergency Care	$125 copay
Lab Services	$0 copay

Monthly Premium	$49 You may be able to lower your premium, if you get Extra Help from Medicare
Part B Premium Monthly Saving	Not Covered
Maximum Out-Of-Pocket Limit	$2,900 per calendar year
Annual Deductible	$0
Primary Care Physician Visits	$0 copay
Specialist Visits	$25 copay
Inpatient Hospital Care	$175 copay per day, per stay: days 1–6 $0 copay per day, per stay: days 7 and beyond
Urgent Care	$20 copay
Emergency Care	$125 copay
Lab Services	$0 copay

Part D Prescription Drug Coverage

Benefit	BayCarePlus Rewards (HMO) H2235-002
Annual Deductible	$0
Tier 1 Preferred Generic	$0 copay
Tier 2 Generic	$10 copay
Tier 3 Preferred Brand	$47 copay
Tier 4 Non-Preferred Brand	40% coinsurance
Tier 5 Specialty Drug	33% coinsurance
Tier 6 – Select Maintenance Drug	$0 copay
Tier 1-4 Mail Order (up to a 100 Day Supply)	$0 / $0 / $125 / 40%
Tier 6 Mail Order (up to a 100 Day Supply)	$0 copay
Diabetic Insulin (One Month Supply)	Tier 1 - N/A Tier 2 - $10 copay Tier 3 - $35 copay Tier 4 - $35 copay Tier 5 - N/A
Initial Coverage Limit	$2,000
View the drugs covered by this plan

Benefit	BayCarePlus Complete (HMO) H2235-001
Annual Deductible	$0
Tier 1 Preferred Generic	$0 copay
Tier 2 Generic	$3 copay
Tier 3 Preferred Brand	$35 copay
Tier 4 Non-Preferred Brand	31% coinsurance
Tier 5 Specialty Drug	33% coinsurance
Tier 6 – Select Maintenance Drug	$0 copay
Tier 1-4 Mail Order (up to a 100 Day Supply)	$0 / $0 / $95 / 31%
Tier 6 Mail Order (up to a 100 Day Supply)	$0 copay
Diabetic Insulin (One Month Supply)	Tier 1 - N/A Tier 2 - $3 copay Tier 3 - $35 copay Tier 4 - $35 copay Tier 5 - N/A
Initial Coverage Limit	$2,000
View the drugs covered by this plan

Benefit	BayCarePlus Premier (HMO) H2235-003
Annual Deductible	$0
Tier 1 Preferred Generic	$0 copay
Tier 2 Generic	$0 copay
Tier 3 Preferred Brand	$30 copay
Tier 4 Non-Preferred Brand	31% coinsurance
Tier 5 Specialty Drug	33% coinsurance
Tier 6 – Select Maintenance Drug	$0 copay
Tier 1-4 Mail Order (up to a 100 Day Supply)	$0 / $0 / $80 / 31%
Tier 6 Mail Order (up to a 100 Day Supply)	$0 copay
Diabetic Insulin (One Month Supply)	Tier 1 - N/A Tier 2 - $0 copay Tier 3 - $30 copay Tier 4 - $35 copay Tier 5 - N/A
Initial Coverage Limit	$2,000
View the drugs covered by this plan

Annual Deductible	$0
Tier 1 Preferred Generic	$0 copay
Tier 2 Generic	$0 copay
Tier 3 Preferred Brand	$30 copay
Tier 4 Non-Preferred Brand	31% coinsurance
Tier 5 Specialty Drug	33% coinsurance
Tier 6 – Select Maintenance Drug	$0 copay
Tier 1-4 Mail Order (up to a 100 Day Supply)	$0 / $0 / $80 / 31%
Tier 6 Mail Order (up to a 100 Day Supply)	$0 copay
Diabetic Insulin (One Month Supply)	Tier 1 - N/A Tier 2 - $0 copay Tier 3 - $30 copay Tier 4 - $35 copay Tier 5 - N/A
Initial Coverage Limit	$2,000
View the drugs covered by this plan

Annual Deductible	$0
Tier 1 Preferred Generic	$0 copay
Tier 2 Generic	$0 copay
Tier 3 Preferred Brand	$30 copay
Tier 4 Non-Preferred Brand	31% coinsurance
Tier 5 Specialty Drug	33% coinsurance
Tier 6 – Select Maintenance Drug	$0 copay
Tier 1-4 Mail Order (up to a 100 Day Supply)	$0 / $0 / $80 / 31%
Tier 6 Mail Order (up to a 100 Day Supply)	$0 copay
Diabetic Insulin (One Month Supply)	Tier 1 - N/A Tier 2 - $0 copay Tier 3 - $30 copay Tier 4 - $35 copay Tier 5 - N/A
Initial Coverage Limit	$2,000
View the drugs covered by this plan

Annual Deductible	$0
Tier 1 Preferred Generic	$0 copay
Tier 2 Generic	$0 copay
Tier 3 Preferred Brand	$30 copay
Tier 4 Non-Preferred Brand	31% coinsurance
Tier 5 Specialty Drug	33% coinsurance
Tier 6 – Select Maintenance Drug	$0 copay
Tier 1-4 Mail Order (up to a 100 Day Supply)	$0 / $0 / $80 / 31%
Tier 6 Mail Order (up to a 100 Day Supply)	$0 copay
Diabetic Insulin (One Month Supply)	Tier 1 - N/A Tier 2 - $0 copay Tier 3 - $30 copay Tier 4 - $35 copay Tier 5 - N/A
Initial Coverage Limit	$2,000
View the drugs covered by this plan

Extra Benefit Highlights

Benefit	BayCarePlus Rewards (HMO) H2235-002
Dental (Base Option)	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $2,000 for comprehensive dental.
Optional Comprehensive Dental*	Monthly Premium: $50.20 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental
Vision	$0 copay for routine eye exam $0 copay or a pair of eyeglasses (lenses and frames) or contacts $150 max benefit (non-Medicare-covered eyewear) per calendar year
Hearing Aids (Up to two hearing aids every calendar year [one per ear])	$599 or $899 copay per hearing aid
Over-the-Counter (OTC) Items	Not covered
Transportation Assistance	Not covered
Meals	Not covered
Travel Benefits	Emergency or urgent care coverage if you’re making a trip out of state or country.
Important Documents (All Plans)	Provider Directory Drug Formulary Star Ratings Formulary Change Notice Summary of Benefits
Documentos Importantes (Todos los planes)	Directorio d Proveedores Formulario de Medicamentos Recetados Calificaciones por Estrellas Resumen de Beneficios (Disponible próximamente)
Important Documents (Plan Specific)	Evidence of Coverage Annual Notice of Change
Documentos Importantes (Específico del Plan)	Evidencial de Cobertura Aviso Anual de Cambio

Benefit	BayCarePlus Complete (HMO) H2235-001
Dental (Base Option)	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $3,000 for comprehensive dental.
Optional Comprehensive Dental*	Monthly Premium: $49.60 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental
Vision	$0 copay for routine eye exam $0 copay for a pair of eyeglasses (lenses and frames) or contacts $300 max benefit (non-Medicare-covered eyewear) per calendar year for eyeglass (lenses and frames) or $350 max benefit per year for contacts
Hearing Aids (Up to two hearing aids every calendar year [one per ear])	$699 or $999 copay per hearing aid
Over-the-Counter (OTC) Items	$140 per quarter
Transportation Assistance	$0 copay for 16 one-way trips to approved locations per calendar year
Meals	56 home-delivered, post-discharge meals per calendar year
Travel Benefits	Emergency or urgent care coverage if you’re making a trip out of state or country.
Important Documents (All Plans)	Provider Directory Drug Formulary Star Ratings Formulary Change Notice Summary of Benefits
Documentos Importantes (Todos los planes)	Directorio d Proveedores Formulario de Medicamentos Recetados Calificaciones por Estrellas Resumen de Beneficios (Disponible próximamente)
Important Documents (Plan Specific)	Evidence of Coverage Annual Notice of Change
Documentos Importantes (Específico del Plan)	Evidencial de Cobertura Aviso Anual de Cambio

Benefit	BayCarePlus Premier (HMO) H2235-003
Dental (Base Option)	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $3,000 for comprehensive dental.
Optional Comprehensive Dental*	Monthly Premium: $49.60 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental
Vision	$0 copay for routine eye exam $0 copay for a pair of eyeglasses (lenses and frames) or contacts $300 max benefit (non-Medicare-covered eyewear) per calendar year for eyeglass (lenses and frames) or $350 max benefit per year for contacts
Hearing Aids (Up to two hearing aids every calendar year [one per ear])	$599 or $899 copay per hearing aid
Over-the-Counter (OTC) Items	$175 per quarter
Transportation Assistance	$0 copay for 24 one-way trips to approved locations per calendar year
Meals	56 home-delivered, post-discharge meals per calendar year
Travel Benefits	Emergency or urgent care coverage if you’re making a trip out of state or country.
Important Documents (All Plans)	Provider Directory Drug Formulary Star Ratings Formulary Change Notice Summary of Benefits
Documentos Importantes (Todos los planes)	Directorio d Proveedores Formulario de Medicamentos Recetados Calificaciones por Estrellas Resumen de Beneficios (Disponible próximamente)
Important Documents (Plan Specific)	Evidence of Coverage Annual Notice of Change
Documentos Importantes (Específico del Plan)	Evidencial de Cobertura Aviso Anual de Cambio

Dental (Base Option)	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $3,000 for comprehensive dental.
Optional Comprehensive Dental*	Monthly Premium: $49.60 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental
Vision	$0 copay for routine eye exam $0 copay for a pair of eyeglasses (lenses and frames) or contacts $300 max benefit (non-Medicare-covered eyewear) per calendar year for eyeglass (lenses and frames) or $350 max benefit per year for contacts
Hearing Aids (Up to two hearing aids every calendar year [one per ear])	$599 or $899 copay per hearing aid
Over-the-Counter (OTC) Items	$175 per quarter
Transportation Assistance	$0 copay for 24 one-way trips to approved locations per calendar year
Meals	56 home-delivered, post-discharge meals per calendar year
Travel Benefits	Emergency or urgent care coverage if you’re making a trip out of state or country.
Important Documents (All Plans)	Provider Directory Drug Formulary Star Ratings Formulary Change Notice Summary of Benefits
Documentos Importantes (Todos los planes)	Directorio d Proveedores Formulario de Medicamentos Recetados Calificaciones por Estrellas Resumen de Beneficios (Disponible próximamente)
Important Documents (Plan Specific)	Evidence of Coverage Annual Notice of Change
Documentos Importantes (Específico del Plan)	Evidencial de Cobertura Aviso Anual de Cambio

Dental (Base Option)	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $3,000 for comprehensive dental.
Optional Comprehensive Dental*	Monthly Premium: $49.60 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental
Vision	$0 copay for routine eye exam $0 copay for a pair of eyeglasses (lenses and frames) or contacts $300 max benefit (non-Medicare-covered eyewear) per calendar year for eyeglass (lenses and frames) or $350 max benefit per year for contacts
Hearing Aids (Up to two hearing aids every calendar year [one per ear])	$599 or $899 copay per hearing aid
Over-the-Counter (OTC) Items	$175 per quarter
Transportation Assistance	$0 copay for 24 one-way trips to approved locations per calendar year
Meals	56 home-delivered, post-discharge meals per calendar year
Travel Benefits	Emergency or urgent care coverage if you’re making a trip out of state or country.
Important Documents (All Plans)	Provider Directory Drug Formulary Star Ratings Formulary Change Notice Summary of Benefits
Documentos Importantes (Todos los planes)	Directorio d Proveedores Formulario de Medicamentos Recetados Calificaciones por Estrellas Resumen de Beneficios (Disponible próximamente)
Important Documents (Plan Specific)	Evidence of Coverage Annual Notice of Change
Documentos Importantes (Específico del Plan)	Evidencial de Cobertura Aviso Anual de Cambio

Dental (Base Option)	0% coinsurance for covered preventive dental services including oral exams, X-rays and cleanings 0% – 50% coinsurance for covered comprehensive dental depending on the service Annual maximum of $3,000 for comprehensive dental.
Optional Comprehensive Dental*	Monthly Premium: $49.60 0% coinsurance for preventative dental services including oral exams, X-rays and cleanings 0% coinsurance for comprehensive dental services Annual maximum of $4,000 for comprehensive dental
Vision	$0 copay for routine eye exam $0 copay for a pair of eyeglasses (lenses and frames) or contacts $300 max benefit (non-Medicare-covered eyewear) per calendar year for eyeglass (lenses and frames) or $350 max benefit per year for contacts
Hearing Aids (Up to two hearing aids every calendar year [one per ear])	$599 or $899 copay per hearing aid
Over-the-Counter (OTC) Items	$175 per quarter
Transportation Assistance	$0 copay for 24 one-way trips to approved locations per calendar year
Meals	56 home-delivered, post-discharge meals per calendar year
Travel Benefits	Emergency or urgent care coverage if you’re making a trip out of state or country.
Important Documents (All Plans)	Provider Directory Drug Formulary Star Ratings Formulary Change Notice Summary of Benefits
Documentos Importantes (Todos los planes)	Directorio d Proveedores Formulario de Medicamentos Recetados Calificaciones por Estrellas Resumen de Beneficios (Disponible próximamente)
Important Documents (Plan Specific)	Evidence of Coverage Annual Notice of Change
Documentos Importantes (Específico del Plan)	Evidencial de Cobertura Aviso Anual de Cambio

*The Delta Dental plan will pay benefits for covered services provided by a non-participating provider. However, a non-participating provider may charge you more than the Maximum Plan Allowance payable under this Medicare Advantage plan and you’ll be responsible for all cost-sharing charges. See the Evidence of Coverage for full details.

Important Disclaimers

For accommodations of persons with special needs at meetings call (877) 549-1741 (TTY: 711).

BayCare Select Health Plans is an HMO plan with a Medicare contract. Enrollment in BayCare Select Health Plans depends on contract renewal. All BayCare Select Health Plans include Part D drug coverage.

To enroll, you must have both Medicare Parts A and B and reside in the plan service area.

You must continue to pay your Medicare Part B premium. Enrollment in a BayCare Select Health Plan may be limited to specific times of the year.

Members must use plan providers except in emergency or urgent care situations. If a member obtains care from an out-of-network provider without prior approval from BayCare Select Health Plans, neither Medicare nor BayCare Select Health Plans will be responsible for the costs.

Information on our utilization management processes, including prior authorization, concurrent review, post service review and appeals, can be found online at Member.BayCarePlus.org.

BayCare Select Health Plans complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

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Primary Care Physician Visits

Specialist Visits

Inpatient Hospital Care

Urgent Care

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Tier 3 Preferred Brand

Tier 4 Non-Preferred Brand

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Tier 6 – Select Maintenance Drug

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Tier 6 Mail Order (up to a 100 Day Supply)

Diabetic Insulin (One Month Supply)

Initial Coverage Limit

View the drugs covered by this plan

Dental (Base Option)

Optional Comprehensive Dental*

Vision

Hearing Aids (Up to two hearing aids every calendar year [one per ear])

Over-the-Counter (OTC) Items

Transportation Assistance

Meals

Travel Benefits

Important Documents (All Plans)

Documentos Importantes (Todos los planes)

Important Documents (Plan Specific)

Documentos Importantes (Específico del Plan)

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