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Occlusal guards (once each 36 months).

Guardas oclusales (una vez cada 36 meses).

Repair or reline of occlusal guard (once each 24 months).

Reparación o rebasado de guarda oclusal (una vez cada 24 meses).

Fitness Benefit - you can be reimbursed up to $300 for membership and class fees paid to an in-person health club with a variety of cardiovascular and strength-training equipment; an in-person fitness studio that provides instructor-led group classes for cardiovascular and strength-training programs; a virtual/online membership, subscription, program, or class that provides cardiovascular and strength-training using a digital platform; or for home fitness equipment. This benefit also includes facilities with pools, water aerobics (and other classes), aqua therapy or a pool-only facility on or after January 1, 2023. You can request this reimbursement each calendar year; requests must be submitted by March 31 of the following year. You cannot be reimbursed for initiation fees, or fees for personal training sessions, country clubs, social clubs (like ski, tennis, hiking), sports teams, spas, instructional dance, gymnastics, martial arts schools or clothing.

(La exención o reducción del costo compartido de las consultas de control general se aplica a determinados servicios ambulatorios de salud mental y/o abuso de sustancias, como la psicoterapia, incluidas las evaluaciones y las consultas de administración de medicamentos. El límite total de consultas de control general se combina para incluir todas las consultas en persona o a través del servicio de telesalud para tratar afecciones específicas de salud mental y abuso de sustancias).

(The waived or reduced cost share for the value care visits apply to specific outpatient mental health and/or substance use services, such as psychotherapy, including evaluations, and medication management visits. The overall value care visit limit is combined to include all in-person and telehealth visits to treat defined mental health and substance use conditions.)

(La exención o reducción del costo compartido de las consultas de control general se aplica a determinados servicios ambulatorios de salud mental y/o abuso de sustancias, como la psicoterapia, incluidas las evaluaciones y las consultas de administración de medicamentos. El límite total de consultas de control general se combina para incluir todas las consultas en persona o a través del servicio de telesalud para tratar afecciones específicas de salud mental y abuso de sustancias).