updates

summary-of-benefits-paragraphs.txt

@@ -31,39 +31,38 @@ This plan does not have a medical deductible.  This plan does not have a Pharmac
 The maximum out-of-pocket responsibility  is $3,900 for in-network costs.  The most you pay for copays, coinsurance and other costs for covered medical services for the year. 
 
 Here are the Covered Medical and Hospital Benefits.
-Acute inpatient hospital care $250 copay per day for days 1-7 .
-$0 copay per day for days 8-90 .
+Acute inpatient hospital care has a $250 copay per day for days 1 through 7 and a $0 copay per day for days 8 through 90 .
 Your plan covers an unlimited number of days for an inpatient stay. 
-Outpatient hospital coverage . Outpatient surgery at Outpatient Hospital: $250 copay .
-Outpatient surgery at Ambulatory Surgical Center: $200 copay .
+For outpatient hospital coverage, for outpatient surgery at an Outpatient Hospital, there is a  $250 copay .
+For outpatient surgery at an Ambulatory Surgical Center, there is a $200 copay .
 For primary care Doctor visits , the copay is  $0.
 For Specialists  the copay is $15.
-You do not need a referral to receive covered services from plan providers. Certain procedures, services and drugs may need advance approval from your plan. This is called a "prior authorization" or "preauthorization." Please contact your PCP or refer to the Evidence of Coverage (EOC) for services that require a prior authorization from the plan.
-Preventive care Our plan covers many preventive services at no cost when you see an in-network provider including the following:
-• Abdominal aortic aneurysm screening 
-• Alcohol misuse counseling 
-• Bone mass measurement 
-• Breast cancer screening (mammogram) 
-• Cardiovascular disease (behavioral therapy) 
-• Cardiovascular screenings 
-• Cervical and vaginal cancer screening 
-• Colorectal cancer screenings (colonoscopy, fecal occult blood test, 
-flexible sigmoidoscopy) 
-• Depression screening 
-• Diabetes screenings 
-• HIV screening 
-• Medical nutrition therapy services 
-• Obesity screening and counseling 
-• Prostate cancer screenings (PSA) 
-• Sexually transmitted infections screening and counseling 
-• Tobacco use cessation counseling (counseling for people with no 
-sign of tobacco-related disease) 
-• Vaccines, including flu shots, hepatitis B shots, pneumococcal shots 
-• "Welcome to Medicare" preventive visit (one-time) 
-• Annual Wellness Visit 
-• Lung cancer screening 
-• Routine physical exam 
-• Medicare diabetes prevention program 
+
+You do not need a referral to receive covered services from plan providers. Certain procedures, services and drugs may need advance approval from your plan. This is called a "prior authorization" or "preauthorization." Please contact your PCP or refer to the Evidence of Coverage (EOC) for services that require a prior authorization from the plan. PCP means your Primary Care Provider.  Your Primary Care Provider is your primary doctor.
+
+For preventive care, our plan covers many preventive services at no cost when you see an in-network provider. 
+Abdominal aortic aneurysm screening is a preventative service.
+Alcohol misuse counseling  is a preventative service.
+Bone mass measurement  is a preventative service.
+Breast cancer screening (mammogram)  is a preventative service.
+Cardiovascular disease (behavioral therapy)  is a preventative service.
+Cardiovascular screenings  is a preventative service.
+Cervical and vaginal cancer screening  is a preventative service.
+Colorectal cancer screenings (colonoscopy, fecal occult blood test, flexible sigmoidoscopy)  is a preventative service.
+Depression screening  is a preventative service.
+Diabetes screenings  is a preventative service.
+HIV screening  is a preventative service.
+Medical nutrition therapy services  is a preventative service.
+Obesity screening and counseling  is a preventative service.
+Prostate cancer screenings (PSA)  is a preventative service.
+Sexually transmitted infections screening and counseling  is a preventative service.
+Tobacco use cessation counseling (counseling for people with no sign of tobacco-related disease)  is a preventative service.
+Vaccines, including flu shots, hepatitis B shots, pneumococcal shots  is a preventative service.
+"Welcome to Medicare" preventive visit (one-time)  is a preventative service.
+Annual Wellness Visit  is a preventative service.
+Lung cancer screening  is a preventative service.
+Routine physical exam  is a preventative service.
+Medicare diabetes prevention program  is a preventative service.
 Any additional preventive services approved by Medicare during the contract year will be covered. 
 
 Here is information about emergency care .
@@ -77,13 +76,13 @@ medical attention.
 
 Here is information about OUTPATIENT CARE AND SERVICES .
 For diagnostic services, labs and imaging , cost share may vary depending on the service and where service is provided .
-• Diagnostic mammography: $0 to $15 copay 
-• Diagnostic colonoscopy $0 copay 
-• Diagnostic radiology: $180 to $300 copay 
-• Lab services: $0 to $20 copay 
-• Diagnostic tests and procedures: $0 to $100 copay 
-• Outpatient X-rays: $0 to $75 copay 
-• Radiation therapy: $15 copay or 20% of the cost 
+For Diagnostic mammography there is a  $0 to $15 copay .
+For Diagnostic colonoscopy there is a $0 copay .
+For Diagnostic radiology, there is a $180 to $300 copay .
+For Lab services, there is a $0 to $20 copay .
+For Diagnostic tests and procedures there is a $0 to $100 copay .
+For Outpatient X-rays there is a $0 to $75 copay .
+For Radiation therapy, there is a  $15 copay or 20% of the cost .
 
 Here is information about Hearing benefits.
 Medicare-covered hearing exam: $15 copay