In-networkUrgentCare visitcostspecialistvisit out-of-networkcostIn-networkinpatientmentalhealth staycostcoinsuranceforanesthesiado yourequire areferral tosee aspecialist?out-of-networkemergencyroom visitcostin-networkdurablemedicalequipmentcostPlanTypeIn-networkpreventativecare/screeningcostGenericdrugs in-networkcostservicesnotcoveredby planIndividualDeductiblepreferredbrand RXout-of-network costOut-of-networkdiagnosistest costspecialistvisit in-networkcostin-networkphysician/surgeonfeesHospitalstay in-networkcostOut-of-networkskillednursing costIn-networkout-of-PocketlimitCoveragePeriodfamilydeductibleemergencymedicaltransportationin-networkcostnon-preferredbrand drugsout ofnetwork costOut-of-pocketlimitexclusionsnon-preferredbrand drugsin-networkcostIn-networkimagingcostOut-of-networkout-of-pocket limitspecialtydrugs in-networkcostPrimarycare visitin-networkcostIn-networkOutpatientMentalhealth carecosthospitalstay out-of-networkcostIn-networkUrgentCare visitcostspecialistvisit out-of-networkcostIn-networkinpatientmentalhealth staycostcoinsuranceforanesthesiado yourequire areferral tosee aspecialist?out-of-networkemergencyroom visitcostin-networkdurablemedicalequipmentcostPlanTypeIn-networkpreventativecare/screeningcostGenericdrugs in-networkcostservicesnotcoveredby planIndividualDeductiblepreferredbrand RXout-of-network costOut-of-networkdiagnosistest costspecialistvisit in-networkcostin-networkphysician/surgeonfeesHospitalstay in-networkcostOut-of-networkskillednursing costIn-networkout-of-PocketlimitCoveragePeriodfamilydeductibleemergencymedicaltransportationin-networkcostnon-preferredbrand drugsout ofnetwork costOut-of-pocketlimitexclusionsnon-preferredbrand drugsin-networkcostIn-networkimagingcostOut-of-networkout-of-pocket limitspecialtydrugs in-networkcostPrimarycare visitin-networkcostIn-networkOutpatientMentalhealth carecosthospitalstay out-of-networkcost

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