PPO Select^® Saver Series III

Policy Form Number: PPO-SELSAVER-3

Preventive Care

PPO Select Saver emphasizes preventive care with coverage for routine physicals, immunizations and diagnostic tests. When you use network providers for your medical care, office visits and certain office setting services are generally covered at 75% of allowable amount, subject to deductible. Immunizations for children through age 7, are covered 100% of allowable amount.

View Office Setting Services for PPO Select Saver

• General Benefits
• Preventive Care
• Child-Only Coverage
• Prescription Drug Program
• View Outline of Coverage