Your Non-Participating Provider Deductible amount is determined by the number of Insureds enrolled in this Policy, as follows: ■ Individual Deductible: $2,500 per Year for each Insured. Once you have satisfied your Non- Participating Provider Deductible, no further Non-Participating Provider ...
Page 5 of 10 Common Medical Event Services You May Need Rehabilitation Services Habilitation Services If your child needs dental or eye care Skilled Nursing Care Durable medical equipment Hospice service Eye exam Glasses Dental check-up Your Cost If You Use a In- Network Provider 0% coinsurance ...