Cleveland Clinic EHP Summary of Benefits and Coverage (SBC) click here
Below are the 2020 Plan documents for your Medical and Prescription Drug benefits. For further questions please contact cehpao@ccf.org
January 2020 Prescription Drug Formulary
Summary Plan Description (SPD)
Pharmacy Handbook
Maintenance Drug List - January 2020
EHP Prescription Drug Formulary Updates For April 2020
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.
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