Cleveland Clinic EHP Summary of Benefits and Coverage (SBC) click here
View the full EHP Summary Plan Description (SPD) or the Prescription Drug Benefit and Formulary Handbook by clicking on the images below. If you would like a paper copy of the SPD please email email@example.com
Medicare bars payment for items and services rendered by physicians to immediate relatives of the physician, to the physician’s partner in a partnership or to members of their household. The exclusion also includes services provided incident to. “Immediate relatives” is defined to include husband and wife; natural or adoptive parent, child and sibling; stepparent, stepchild, stepbrother, and stepsister; father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, and sister-in-law; grandparent and grandchild; and spouse of grandparent and grandchild.
Effective September 1, 2017: Medical Director Review required for Gamma Knife Therapy.
Cell-Free Fetal DNA-Based Prenatal Screening for Fetal Aneuploidy will be covered if precertification criteria is met. MaterniT21 by Sequenon must be ordered by a Cleveland Clinic physician.
Health Benefits Program Member Rights and Responsibilities click here