Out-of-networkskillednursing costIn-networkout-of-PocketlimitHospitalstay in-networkcostPrimarycare visitin-networkcostin-networkdurablemedicalequipmentcostGenericdrugs in-networkcostout-of-networkemergencyroom visitcostCoveragePeriodnon-preferredbrand drugsin-networkcostIn-networkUrgentCare visitcostIndividualDeductibleIn-networkinpatientmentalhealth staycostOut-of-pocketlimitexclusionsPlanTypespecialtydrugs in-networkcostOut-of-networkdiagnosistest costOut-of-networkout-of-pocket limitIn-networkOutpatientMentalhealth carecostspecialistvisit in-networkcostcoinsuranceforanesthesiaIn-networkpreventativecare/screeningcostnon-preferredbrand drugsout ofnetwork costdo yourequire areferral tosee aspecialist?preferredbrand RXout-of-network costhospitalstay out-of-networkcostIn-networkimagingcostspecialistvisit out-of-networkcostemergencymedicaltransportationin-networkcostin-networkphysician/surgeonfeesservicesnotcoveredby planfamilydeductibleOut-of-networkskillednursing costIn-networkout-of-PocketlimitHospitalstay in-networkcostPrimarycare visitin-networkcostin-networkdurablemedicalequipmentcostGenericdrugs in-networkcostout-of-networkemergencyroom visitcostCoveragePeriodnon-preferredbrand drugsin-networkcostIn-networkUrgentCare visitcostIndividualDeductibleIn-networkinpatientmentalhealth staycostOut-of-pocketlimitexclusionsPlanTypespecialtydrugs in-networkcostOut-of-networkdiagnosistest costOut-of-networkout-of-pocket limitIn-networkOutpatientMentalhealth carecostspecialistvisit in-networkcostcoinsuranceforanesthesiaIn-networkpreventativecare/screeningcostnon-preferredbrand drugsout ofnetwork costdo yourequire areferral tosee aspecialist?preferredbrand RXout-of-network costhospitalstay out-of-networkcostIn-networkimagingcostspecialistvisit out-of-networkcostemergencymedicaltransportationin-networkcostin-networkphysician/surgeonfeesservicesnotcoveredby planfamilydeductible

Summary Benefit Card Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Out-of-network skilled nursing cost
  2. In-network out-of-Pocket limit
  3. Hospital stay in-network cost
  4. Primary care visit in-network cost
  5. in-network durable medical equipment cost
  6. Generic drugs in-network cost
  7. out-of-network emergency room visit cost
  8. Coverage Period
  9. non-preferred brand drugs in-network cost
  10. In-network Urgent Care visit cost
  11. Individual Deductible
  12. In-network inpatient mental health stay cost
  13. Out-of-pocket limit exclusions
  14. Plan Type
  15. specialty drugs in-network cost
  16. Out-of-network diagnosis test cost
  17. Out-of-network out-of-pocket limit
  18. In-network Outpatient Mental health care cost
  19. specialist visit in-network cost
  20. coinsurance for anesthesia
  21. In-network preventative care/screening cost
  22. non-preferred brand drugs out of network cost
  23. do you require a referral to see a specialist?
  24. preferred brand RX out-of-network cost
  25. hospital stay out-of-network cost
  26. In-network imaging cost
  27. specialist visit out-of-network cost
  28. emergency medical transportation in-network cost
  29. in-network physician/ surgeon fees
  30. services not covered by plan
  31. family deductible