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Summary of Benefits and Coverage  What this Plan Covers   What You Pay For Covered Services Pratt Regional Medical Center ...
Do you need a referral to see a specialist   No.  You can see the specialist you choose without a referral.  All coinsuran...
Common Medical Event If you need immediate medical attention If you have a hospital stay  Services You May Need Emergency ...
Excluded Services   Other Covered Services  Services Your Plan Generally Does NOT Cover  Check your policy or plan documen...
About these Coverage Examples  This is not a cost estimator. Treatments shown are just examples of how this plan might cov...