coating. 
Refraction is only covered when billed as part of the routine vision  
exam. 
Search for Vision providers in the Medical network of this Medicare  
Advantage plan. 
Mental health services Inpatient: 
•$150 copay per day for days 1-8 
•$0 copay per day for days 9-90 
•Your plan covers up to 190 days in alifetime for inpatient mental 
health care in apsychiatric hospital. 
Outpatient (group and individual therapy visits):  $25 to  $100 copay