SAP Americas offers three comprehensive medical benefit plans through a Point of Service (POS) plan. The plans provide both in-network and out-of-network coverage for necessary hospital, surgical, and other medical care. You can use any provider without a referral; however, there are no claim forms to complete and you will receive more services for your money if you use in-network providers.

For medically necessary services provided outside the preferred provider network, you pay the provider for services rendered, then submit a claim form for reimbursement. All charges are subject to reasonable and customary limitations.

Each plan covers the following eligible expenses for both in-network and out-of-network services:

• Preventive care – Each plan covers 100% for routine physical examinations, including laboratory tests, X-rays, immunizations, and vaccinations for you and your eligible dependents. Eligible dependents include your spouse, same-sex domestic partner, and children up to age 23 (up to age 25 if full-time college students).
• Hospitalization – Each plan covers the cost for a semi-private room and board and miscellaneous charges when you or an eligible dependent is admitted to a hospital.
• Medical/surgical – Each plan covers the cost for doctor office visits, surgery, delivery of a baby, anesthesia, second surgical opinions, pre-admission testing, laboratory, X-rays, and other medically necessary services.
• Outpatient mental illness, alcohol, and drug abuse – Each plan covers inpatient or outpatient treatment for mental or emotional conditions or drug abuse. Payment for these expenses is subject to plan maximums each calendar year.

In addition, a prescription drug plan provides access to a retail pharmacy drug network, which requires a co-pay for generic, preferred brand-name drugs, or non-preferred brand-name drugs. Plus, a mail-order drug program is available that provides a 90-day supply of generic, preferred brand-name, or non-preferred brand-name drugs.