servicesnotcoveredby planspecialtydrugs in-networkcostGenericdrugs in-networkcostfamilydeductibleOut-of-pocketlimitexclusionsOut-of-networkout-of-pocket limitIndividualDeductibleOut-of-networkskillednursing costIn-networkinpatientmentalhealth staycostPrimarycare visitin-networkcostIn-networkOutpatientMentalhealth carecostHospitalstay in-networkcostemergencymedicaltransportationin-networkcostPlanTypespecialistvisit in-networkcostIn-networkout-of-Pocketlimitcoinsuranceforanesthesiaspecialistvisit out-of-networkcostpreferredbrand RXout-of-network costOut-of-networkdiagnosistest costin-networkdurablemedicalequipmentcostIn-networkUrgentCare visitcostIn-networkimagingcostIn-networkpreventativecare/screeningcostnon-preferredbrand drugsin-networkcosthospitalstay out-of-networkcostnon-preferredbrand drugsout ofnetwork costout-of-networkemergencyroom visitcostdo yourequire areferral tosee aspecialist?in-networkphysician/surgeonfeesCoveragePeriodservicesnotcoveredby planspecialtydrugs in-networkcostGenericdrugs in-networkcostfamilydeductibleOut-of-pocketlimitexclusionsOut-of-networkout-of-pocket limitIndividualDeductibleOut-of-networkskillednursing costIn-networkinpatientmentalhealth staycostPrimarycare visitin-networkcostIn-networkOutpatientMentalhealth carecostHospitalstay in-networkcostemergencymedicaltransportationin-networkcostPlanTypespecialistvisit in-networkcostIn-networkout-of-Pocketlimitcoinsuranceforanesthesiaspecialistvisit out-of-networkcostpreferredbrand RXout-of-network costOut-of-networkdiagnosistest costin-networkdurablemedicalequipmentcostIn-networkUrgentCare visitcostIn-networkimagingcostIn-networkpreventativecare/screeningcostnon-preferredbrand drugsin-networkcosthospitalstay out-of-networkcostnon-preferredbrand drugsout ofnetwork costout-of-networkemergencyroom visitcostdo yourequire areferral tosee aspecialist?in-networkphysician/surgeonfeesCoveragePeriod

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