Does the Non-specialist office visit copayment apply to gynecological visits as well?
Yes, however the copayment is for the office visit only. All other services received during the office visit are subject to the deductible and coinsurance. However, in-network preventive services, as identified in Section IV. (Benefits) item C. (Clinical Preventive Services), performed in conjunction with an in-network preventive visit are not subject to the Deductible. Coinsurance will still apply to these services.PRESCRIPTION DRUGSHow do I know if a prospect’s medications will be too costly for approval? In accordance with our Underwriting Guidelines, if Presbyterian’s share of prescription drug costs exceeds 30% of premium, the application is declined. The decision is based on our calculations. You can approximate our calculations on behalf of your client by obtaining drug costs from Web pharmacies (e.g., familymeds.com, and drugstore.org) and applying applicable copayments. The conditions associated with an applicant’s drugs are sometimes a much larger underwriting factor than the
