Common use of HOW YOUR COVERAGE WORKS Clause in Contracts

HOW YOUR COVERAGE WORKS. Your Agreement provides a wide range of coverage for health care services. The information contained in this section is designed to explain how You can access Your benefits. Xxxxx will cover up to the maximum described below for a Covered Service or supply. Review the SUMMARY OF BENEFITS, the sections titled WHAT IS COVERED – MEDICAL and WHAT IS COVERED – PRESCRIPTION DRUGS for information on Deductibles, Out of Pocket Maximums, Copayments/Coinsurance and any per day, Year or visit limits that may be applied to a particular benefit. Any limits on the number of visits or days covered are stated under the specific benefit and also listed in the SUMMARY OF BENEFITS. These benefits are subject to all other provisions of this Agreement as well, which may also limit benefits or result in benefits not being payable. This is an Exclusive Provider Organization (EPO) Plan. SERVICES MUST BE PERFORMED OR SUPPLIES FURNISHED BY AN IN-NETWORK PROVIDER IN ORDER FOR BENEFITS TO BE • Family planning; • Contraceptive services, including Emergency contraception; • Sterilization, including tubal ligation at the time of labor and delivery; • Infertility treatments; or • Abortion You should obtain more information before You become a Subscriber or select a network Provider. Call Your prospective doctor or clinic, or call Xxxxx at 1-855-Oscar- 55 or access Our website at xxx.xxxxxxx.xxx to ensure that You can obtain the health care services that You need. Providers are independent contractors. Xxxxx is not responsible for any claim for damages or injuries suffered by the Member while receiving care from any Provider. In-Network Providers include Primary Care Physicians / Providers (PCPs), Specialists (Specialty Care Physicians / Providers (SCPs)), other professional Providers, Hospitals, and other Facilities who contract with Us to care for You. Referrals are never needed to visit an In-Network Specialist or a non-physician who provides mental health/substance abuse services. To see a Provider, call their office: • Have Your Identification Card handy. The Provider’s office may ask You for Your ID number, • Tell them You are an Oscar Member, • Tell them the reason for Yourvisit. When You go to the office, be sure to bring Your Identification Card with You.

HOW YOUR COVERAGE WORKS. Your Agreement provides a wide range of coverage for health care services. The information contained in this section is designed to explain how You can access Your benefits. Xxxxx will cover up to the maximum described below for a Covered Service or supply. Review the SUMMARY OF BENEFITS, the sections titled called WHAT IS COVERED – MEDICAL and WHAT IS COVERED – PRESCRIPTION DRUGS for information on Deductibles, Out of Pocket Maximums, Copayments/Coinsurance and any per day, Year or visit limits that may be applied to a particular benefit. Any limits on the number of visits or days covered are stated under the specific benefit and also listed in the SUMMARY OF BENEFITS. These benefits are subject to all other provisions of this Agreement as well, which may also limit benefits or result in benefits not being payable. This is an Exclusive Provider Organization (EPO) Plan. SERVICES MUST BE PERFORMED OR SUPPLIES FURNISHED BY AN IN-NETWORK PROVIDER IN ORDER FOR BENEFITS TO BE • Family planning; • Contraceptive services, including Emergency contraception; • Sterilization, including tubal ligation at the time of labor and delivery; • Infertility treatments; or • Abortion Abortion. You should obtain more information before You become a Subscriber or select a network Provider. Call Your prospective doctor or clinic, or call Xxxxx at 1-855-Oscar- 55 or access Our website at xxx.xxxxxxx.xxx to ensure that You can obtain the health care services that You need. Providers are independent contractors. Xxxxx is not responsible for any claim for damages or injuries suffered by the Member while receiving care from any Provider. In-Network Providers include Primary Care Physicians / Providers (PCPs), Specialists (Specialty Care Physicians / Providers (SCPs)), other professional Providers, Hospitals, and other Facilities who contract with Us to care for You. Referrals are never needed to visit an In-Network Specialist or a non-physician who provides mental health/substance abuse services. To see a Provider, call their office: • Have Your Identification Card handy. The Provider’s office may ask You for Your ID number, ; • Tell them You are an Oscar Member, • Tell them the reason for YourvisitYour visit. When You go to the office, be sure to bring Your Identification Card with You.

HOW YOUR COVERAGE WORKS. Your Agreement provides a wide range of coverage for health care services. The information contained in this section is designed to explain how You can access Your benefits. Xxxxx will cover up to the maximum described below for a Covered Service or supply. Review the SUMMARY OF BENEFITS, the sections titled called WHAT IS COVERED – MEDICAL and WHAT IS COVERED – PRESCRIPTION DRUGS for information on Deductibles, Out of Pocket Maximums, Copayments/Coinsurance and any per day, Year or visit limits that may be applied to a particular benefit. Any limits on the number of visits or days covered are stated under the specific benefit and also listed in the SUMMARY OF BENEFITS. These benefits are subject to all other provisions of this Agreement as well, which may also limit benefits or result in benefits not being payable. This is an Exclusive Provider Organization (EPO) Plan. SERVICES MUST BE PERFORMED OR SUPPLIES FURNISHED BY AN IN-NETWORK PROVIDER IN ORDER FOR BENEFITS TO BE • Authorized Referrals and Covered Services received under the second exception are provided at in-network Cost-Sharing. ● Family planning; • ● Contraceptive services, including Emergency contraception; • ● Sterilization, including tubal ligation at the time of labor and delivery; • ● Infertility treatments; or • Abortion ● Abortion. You should obtain more information before You become a Subscriber or select a network Provider. Call Your prospective doctor or clinic, or call Xxxxx at 1-855-Oscar- 55 Oscar-55 or access Our website at xxx.xxxxxxx.xxx to ensure that You can obtain the health care services that You need. Providers are independent contractors. Xxxxx is not responsible for any claim for damages or injuries suffered by the Member while receiving care from any Provider. In-Network Providers include Primary Care Physicians / Providers (PCPs), Specialists (Specialty Care Physicians / Providers (SCPs)), other professional Providers, Hospitals, and other Facilities who contract with Us to care for You. Referrals are never needed to visit an In-Network Specialist or a non-physician who provides mental health/substance abuse services. To see a Provider, call their office: • ● Have Your Identification Card handy. The Provider’s office may ask You for Your ID number, • ; ● Tell them You are an Oscar Member, • ● Tell them the reason for YourvisitYour visit. When You go to the office, be sure to bring Your Identification Card with You.

HOW YOUR COVERAGE WORKS. Your Agreement provides a wide range of coverage for health care services. The information contained in this section is designed to explain how You can access Your benefits. Xxxxx will cover up to the maximum described below for a Covered Service or supply. Review the SUMMARY OF BENEFITS, the sections titled WHAT IS COVERED – MEDICAL and WHAT IS COVERED – PRESCRIPTION DRUGS for information on Deductibles, Out of Pocket Maximums, Copayments/Coinsurance and any per day, Year or visit limits that may be applied to a particular benefit. Any limits on the number of visits or days covered are stated under the specific benefit and also listed in the SUMMARY OF BENEFITS. These benefits are subject to all other provisions of this Agreement as well, which may also limit benefits or result in benefits not being payable. This is an Exclusive Provider Organization (EPO) Plan. SERVICES MUST BE PERFORMED OR SUPPLIES FURNISHED BY AN IN-NETWORK PROVIDER IN ORDER FOR BENEFITS TO BE • Family planning; • Contraceptive services, including Emergency contraception; • Sterilization, including tubal ligation at the time of labor and delivery; • Infertility treatments; or • Abortion You should obtain more information before You become a Subscriber or select a network Provider. Call Your prospective doctor or clinic, or call Xxxxx at 1-855-Oscar- 55 or access Our website at xxx.xxxxxxx.xxx to ensure that You can obtain the health care services that You need. Providers are independent contractors. Xxxxx is not responsible for any claim for damages or injuries suffered by the Member while receiving care from any Provider. In-Network Providers include Primary Care Physicians / Providers (PCPs), Specialists (Specialty Care Physicians / Providers (SCPs)), other professional Providers, Hospitals, and other Facilities who contract with Us to care for You. Referrals are never needed to visit an In-Network Specialist or a non-physician who provides mental health/substance abuse services. To see a Provider, call their office: • Have Your Identification Card handy. The Provider’s office may ask You for Your ID number, • Tell them You are an Oscar Member, • Tell them the reason for YourvisitYour visit. When You go to the office, be sure to bring Your Identification Card with You.