What services does CHAND cover?

CHAND covers these services and more, up to a lifetime maximum of $1,000,000

Description of Benefits	Benefit Amount as a % of allowed charge after deductible met after coinsurance maximum met	Special Conditions
Inpatient Hospital Services	80% 100%	Preauthorization is required
Outpatient Hospital Services	80% 100%
Physical Therapy	80% 100%	Benefits are based on the medical guidelines established by the lead carrier.
Occupational & Speech Therapy	80% 100%	Maximum of 90 consecutive calendar days per condition beginning on the date of the first therapy treatment for the condition.
Professional Health Care Provider Services Inpatient, Outpatient and Surgical	80%   100%
Home and Office Visits	80% 100%
Well Child Care
Office Visits and Immunizations	80% 100%	To the subscriber's sixth birthday.
Diagnostic Services Lab, X-ray, MRI and Allergy Testing	80%   100%
Wellness Services
Mammography, Pap Smear, Fecal Occult Blood Testing and Prostate Cancer Screening	80% 100%	The number of visits for these services may vary by age group and be subject to a maximum benefit allowance. Refer to the benefit plan for details.
Radiation Therapy, Chemotherapy and Dialysis	80% 100%
Maternity Services Inpatient, Outpatient, Pre and Postnatal Care	80%   100%
Psychiatric & Substance Abuse Services Inpatient, Ambulatory Behavioral Health Care (Partial Hospitalization), Residential Treatment and Outpatient Services	100%/80%     100%	The number of visits, hours or days and the benefit level vary. Out-of-state admissions require prior approval. Preauthorization may be required. Refer to the benefit plan for details.
Emergency Services	80% 100%	Preauthorization is not required.
Ambulance Services	80% 100%
Skilled Nursing Facility Services	80% 100%	Maximum benefit allowance of 120 days per benefit period. Preauthorization is required.
Home Health Care Services	80% 100%	Maximum benefit allowance of 270 visits per benefit period with prior approval from the Lead Carrier.
Hospice Services	80% 100%	Preauthorization is required.
Outpatient Prescription Drugs	80% 100%
Medical Supplies & Equipment Home Medical Equipment, Prosthetics, Orthotics, Therapeutic Devices, Ostomy and Oxygen Supplies	80%     100%	Maximum benefit allowance of $6,000 per benefit period. Additional benefits are available for prosthetic limbs.
Hearing Aids (for subscribers to age 18)	80% 100%	Maximum benefit allowance of $3,000 every three years. Prior approval is required. Benefits are subject to the Medical Supplies & Equipment $6,000 maximum benefit allowance.
Chiropractic Services (optional endorsement)	80% 100%

For premium rates and further details of the coverage, including definitions; exclusions; criteria for medically appropriate and necessary care; credentialing process; confidentiality policy; description of experimental drugs, medical devices or treatments; grievance and appeals process; provider listings; drugs eligible for coverage; reductions or limitations; and the terms under which this benefit plan may be continued, see your Benefits Consultant or write to the lead carrier.

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