State Employee Group Insurance Plan |
Page 1 of 4 Advantage Plan Includes Important Features
The Advantage Plan has some important notable features, including:
- Uniform comprehensive set of benefits across all carriers
- No co-payments charged to you for preventive care such as immunizations, well-child care, annual check-ups, etc.
- Most medical care is coordinated through your Primary Care Clinic (PCC) and you will generally need a referral to see a specialist.
- You may self-refer to certain specialists including obstetricians/gynecologists, chiropractors and mental health/chemical dependency practitioners. You may also self-refer for routine eye exams. How you access this specialty care depends on your plan and possibly your PCC.
- Family members may elect different PCCs (even in a different cost level), but must enroll with the same carrier.
- You can change clinics (within the same benefit level) every month and may change levels (within the same carrier) twice per year.
- Referrals to a specialist’s office will be covered at the same cost level as your PCC.
- You must choose a carrier that is available in the county in which you live or work and select a clinic in your area.
|