b'Blue Cross Blue Shield PPOPROFESSIONAL AND OTHER SERVICESAllergy Shots80% PPO providerPlan Comparison:50% Non-PPO providerNon-Medicare AmbulanceEligible Members 80%Chiropractic Visits80% PPO provider50% Non-PPO providerLimited to 40 visits per yearDentalAccidental care only: coverage providedfor repair of accidental injury to sound natural teethEyeglasses and ContactsNot coveredContact BCBS customer service at 1-800-331-8032 for details on the vision discount program.Maternity80% PPO provider 50% Non-PPO providerPhysician Office Visits80% PPO provider 50% Non-PPO providerPreventive Care Services100% of allowed charges PPO and50% non-PPO providersIncludes routine physical examinations, routine tests, colorectal cancer screening, and immunizationsProsthetic Devices and Medical Equipment80%PPO provider up to purchase price50% Non-PPO provider up to purchase priceVision Screening and ExamsNot coveredContact BCBS customer service at 1-800-331-8032 for details on the vision discount program.CTPF 2024 NON-MEDICARE HEALTH INSURANCE HANDBOOK CTPF 2024 NON-MEDICARE HEALTH INSURANCE HANDBOOK 15'