Coverage for Routine and Complex Procedures

June 12, 2017 09:46
Coverage for Routine and Complex Procedures

In the past, you may have had to go to a hospital for certain healthcare services. Today, many of those same things are done in your doctor’s office. How much you pay for those services depends on if they are routine or complex.

Certain routine treatments are covered under the office visit copayment. But other more complex ones may be applied to your deductible (the amount you must pay before your insurance company starts to pay your claims) or coinsurance (your share of the cost of the service, such as 20%). Always check your official plan documents for the cost sharing amount for specific services. See Routine & Complex Office Procedures.

Check your Summary of Benefits to see what your plan pays for routine and complex procedures. For questions, call Customer Service at 501.228.7111 or 800.235.7111.