Hospital and Ambulance

HomeHomeCareersBenefitsRepresented Retiree (before Jan 1, 2010)Hospital and Ambulance

What's Covered



Reasonable and customary costs for semi-private hospital accommodation.


If you choose a private hospital room, you must pay the difference in cost between semi-private and private accommodation. The plan will only pay the hospital for the semi-private accommodation costs.

Read what exclusions apply to this coverage.


Reasonable and customary charges for ground or air ambulance services, as long as:
  • the service is prescribed by a physician and medically necessary, and
  • the provider is licensed.
You pay the remaining cost.
Read what exclusions apply to this coverage.
Published on February 01, 2016