Cleveland Clinic EHP Summary of Benefits and Coverage (SBC) click here
The 2020 SPD and Prescription Drug Handbooks are currently being updated. In the interim, the charts below are the benefit summaries for the Medical and Prescription Drug benefits. For further questions please contact cehpao@ccf.org
January 2020 Prescription Drug Formulary
Ohio 2020 Benefit Summary
Pharmacy Handbook
Maintenance Drug List - January 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