GBA - Individual Medical Add -Ons

Other Coverages

Three Simple Steps..

1. Open and print the Individual Application

2. Fill everything out and remember to sign and date the form.

3. Fax it back to GBA at 614-410-0999

If you select Extended Prescription Coverage as an Optional Medical Add-On, this benefit:

Covers expenses over basic policy limit of $2000 in prescription costs.
Is only available to individuals with less than two (2) current prescriptions.
Prescription drug purchases are still subject to
the deductible and co-insurance, BUT without
a benefit maximum.