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Nebraska Farm Bureau Official Documents

Benefit and Plan Documents

December 30, 2020

Insure Tiered Network Medica with CHI Health Network
Plan Overview Flier (PDF)
Plan Overview Flier (PDF)
Policy of Coverage (PDF) Policy of Coverage (PDF)

January 1, 2020

Insure Tiered Network Medica with CHI Health Network
Plan Overview Flier (PDF)
Plan Overview Flier (PDF)
Policy of Coverage (PDF) Policy of Coverage (PDF)
Covered Drugs and Network Pharmacies

Look up covered drugs
Find a network pharmacy

 

Note: Your actual costs may vary. Drugs listed in this search tool are subject to change is not all-inclusive. Under your specific plan design, certain drugs listed in this tool may be excluded or require prior authorization to obtain coverage. Check your benefit plan documents for specific coverage information.

Benefit and Plan Documents

December 30, 2020

Insure Tiered Network Medica with CHI Health Network
Plan Overview Flier (PDF)
Plan Overview Flier (PDF)
Policy of Coverage (PDF) Policy of Coverage (PDF)

January 1, 2020

Insure Tiered Network Medica with CHI Health Network
Plan Overview Flier (PDF)
Plan Overview Flier (PDF)
Policy of Coverage (PDF) Policy of Coverage (PDF)
Covered Drugs and Network Pharmacies

Look up covered drugs
Find a network pharmacy

 

Note: Your actual costs may vary. Drugs listed in this search tool are subject to change is not all-inclusive. Under your specific plan design, certain drugs listed in this tool may be excluded or require prior authorization to obtain coverage. Check your benefit plan documents for specific coverage information.

Benefit and Plan Documents

December 30, 2020

Insure Tiered Network Medica with CHI Health Network
Plan Overview Flier (PDF)
Plan Overview Flier (PDF)
Policy of Coverage (PDF) Policy of Coverage (PDF)

January 1, 2020

Insure Tiered Network Medica with CHI Health Network
Plan Overview Flier (PDF)
Plan Overview Flier (PDF)
Policy of Coverage (PDF) Policy of Coverage (PDF)
Covered Drugs and Network Pharmacies

Look up covered drugs
Find a network pharmacy

 

Note: Your actual costs may vary. Drugs listed in this search tool are subject to change is not all-inclusive. Under your specific plan design, certain drugs listed in this tool may be excluded or require prior authorization to obtain coverage. Check your benefit plan documents for specific coverage information.

Date: 7/31/2021 9:59:17 AM Version: 4.0.30319.42000 Machine Name: PWIVE-CDWEB02