Plan Offerings

Cleveland Clinic EHP Summary of Benefits and Coverage (SBC) click here

Below are the 2021 Plan documents for your Medical and Prescription Drug benefits.  For further questions please contact

 January 2021 Prescription Drug Formulary
 Summary Plan Description 2021    

 Pharmacy Handbook January 2021
 Maintenance Drug List January 2021
 EHP Prescription Drug Formulary Updates for March 2021
How to maximize savings in co-pays and co-insurance

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