SUMMARY OF 1997 BENEFIT CHANGES

BENEFIT CHANGES

• Treatment of port wine stains to the face and neck is covered for members through age 18. (See page 13).
• Diagnosis and treatment in a Kaiser Permanente program for eating disorders are now covered services. Previously, these services were excluded under Mental Health. (See page 16).
• Cardiac rehabilitation services are now covered. Previously, these services were excluded under Physical Therapy, Speech Therapy, Occupational Therapy and Rehabilitation. (See page 16).
• The waiting period for all covered transplants has been eliminated. (See page 15).

BENEFIT CLARIFICATIONS

• Covered benefits do not include services not covered under the terms of your Service Agreement even if the services are provided, prescribed or directed by a Physician. (See page 4).
• The supplemental charge for diagnostic outpatient X-ray and laboratory services has been eliminated. The applicable charge will apply to therapeutic X- ray services. (See Benefit Chart).
• All eye surgery which includes radial keratotomy that is solely for the purpose of correcting refractive defects is excluded. (See page 14).
• Members may seek a second opinion from another Physician for medical treatment or procedures. (See page 19).
• Language has been revised to state that if a member fails to purchase the required no fault coverage on an automobile, the member is responsible for payment of up to a combined total of the first $100,000 of medical and rehabilitation costs. Rehabilitation costs alone cannot exceed $50,000. (See page 10).

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NAVIGATION

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Introduction | Benefit Changes | How to Use | Definitions | How Your Plan Works | Who Is Eligible | When Coverage Starts | Benefits And Services | Referrals and Restrictions on Choice of Providers | Emergency Services | Urgent Care | Health Plan's Appeals Procedure | Special Claims Procedures for Medicare Members | General Provisions | Binding Arbitration | Coordination Of currentbenefits | Medicare | What Is Not Covered | When Coverage Stops | Continuation Of Coverage | Customer Satisfaction Procedure | Service Information | Statement Of Financial Condition | Important Phone Numbers | Local Designated Hospitals | Supplemental Benefits | Benefit Chart

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Website for Kaiser of Colorado

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Denver Public Schools
Employee Benefits Department
900 Grant Street, Room 502
Denver, Colorado 80203
(303) 764-3371