•Diabetic monitoring supplies:  $0 copay or  10% to  20% of the cost 
Rehabilitation services •Occupational and speech therapy:  $15 copay 
•Cardiac rehabilitation:  $0 copay 
•Pulmonary rehabilitation:  $0 copay 
Telehealth services 
(in addition to Original 
Medicare) •Primary care provider (PCP):  $0 copay 
•Specialist:  $15 copay 
•Urgent care services:  $0 copay 
•Substance abuse and behavioral health services:  $0 copay H1036234000SB23 Summary of Benefits 15 H1036234000