Estimated Medical Expenses

• Office Visit Copay* N/A

• Copay for prescriptions* N/A

• Projected cost of office visits ($60/visit) $60

• Projected cost of generic prescriptions ($25/fill) $25

• Estimated Lab/x-ray and other expenses $1,200

• Emergency Room Expenses $1,200

• Expenses not subject to Ded. (Eye care, Dental etc.) $500