Benefit & Health Insurance Information
Contact: David Krall, 1-800-445-4493 x 36
Contact: Thomas G. Outwater, 1-781-789-9510
Flex spending for Health and Daycare Cafeteria Plan Advisors: www.cpa125.com
Kimberly Moore or Judi Field 781-848-9848
Payroll savings bonds – Treasures Office
BENEFIT COMPARISON – CITY OF MEDFORD FY 2007-2008
Tufts HMO Tufts POS_____ ________
100% coverage no co-pay 100% coverage no co-pay
Laboratory tests, including Pap smears Laboratory tests, including Pap smears
Immunizations Immunizations
X-ray therapy Diagnostic X-rays and mammograms
Inpatients hospital care and surgery
Inpatient mental health & substance
Abuse care
Co-payment required then 100% coverage Co-payment required then 100% coverage
· Doctor’s office visits Doctor’s office visits
· Routine Physical exams Routine Physical exams
· Well child care Well child care
· Specialist care, consultations Specialist care, consultations
· OB/GYN visits OB/GYN visits
· Prenatal and postnatal care Prenatal and postnatal care
· Speech therapy & short-term physical Speech therapy & short-term physical
· Occupational therapy Occupational therapy
· Annual routine eye exams Annual routine eye exams
· Allergy shots Allergy shots
· Outpatient mental health & substance abuse Outpatient mental health & substance abuse
· Emergency care Emergency care
· Inpatient hospital care & surgery Spinal manipulation (12 visits per cal. year)
· Inpatient mental health & substance
· Abuse care
Unauthorized Care
Co-payment required, then 100% coverage
Emergency care
Allergy shots
Plan covers 80% after annual deductible is met
Doctor’s office visits
Routine physical exams
Well child care
Specialists care, consultations
OB/GYN visits
Prenatal & postnatal care
Speech Therapy & short-term physical Occupational Therapy
Annual routine eye exams
Outpatient mental health & substance abuse Care
Emergency care
Spinal manipulation (12 visits per calendar year)
Day surgery
In hospital care
Inpatient & outpatient mental health care
And substance abuse
Pharmacy Coverage Pharmacy Coverage
· Tier 2 $10.00 Tier 2 $10.00
· Tier 1 $ 5.00 Tier 1 $ 5.00
· Tier 3 $25.00
DELTA DENTAL PREMIER
Type I Type II Type III
Preventive Basic Restorative Major Restorative
Covered at 100% Covered at 80% Covered at 50%
Diagnostic Restorative Prosthodontics
Preventive Oral Surgery Major Restorative
Periodontics Endodontics Endosteal (single-tooth) implants:
Prosthetic Maintenance once within 60 Per inplant
Emergency Dental Care
Calendar year deductible $25.00 per individual or $75.00 per family. Calendar Year Maximum $750.00 and a separate lifetime maximum $1,000.00 for orthodontics per child.
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