PPO Select^® Choice Series III, a Preferred Provider Health Insurance Plan , offers you and your family:

• Affordable, cost-effective health coverage
• Choice of providers and hospitals
• Eight choices of deductible plans
• Flat copay for office visits and variable copay for emergency care
• $5,000,000 lifetime maximum benefit
• Inpatient hospital benefits and professional care
• Outpatient professional care (including office visits, X-rays, lab and diagnostic services)
• 24-hour, worldwide emergency care
• Well-child care, routine physical, vision and hearing exams
• Immunization benefits (up to age seven)
• Human organ and tissue transplant benefits ($300,000 lifetime maximum for transplant benefits and subject to $5,000,000 policy lifetime maximum)
• Preventive Care - $300 maximum per person per calendar year (subject to limitations)
• Home health care, hospice and skilled nursing facility benefits (subject to limitations)
• Physical Medicine Services – In-network, 80 percent of allowable charges up to calendar year maximum of $1,000 per person (in-network and out-of-network combined)
• Any day of the month effective date except the 29th, 30th, or the 31st.
• Age-banded, child-only coverage
• Prescription Drug Card
• Mail-order prescription drug program

Insurance Plan Details

* Texas Department of Insurance Form: PPO-SELCHOICE-3-OLC-2