In-networkinpatientmentalhealth staycostHospitalstay in-networkcostpreferredbrand RXout-of-network costPlanTypeOut-of-networkdiagnosistest costGenericdrugs in-networkcostIn-networkout-of-Pocketlimitin-networkphysician/surgeonfeesIn-networkimagingcostspecialistvisit out-of-networkcostOut-of-networkskillednursing costdo yourequire areferral tosee aspecialist?hospitalstay out-of-networkcostnon-preferredbrand drugsin-networkcostservicesnotcoveredby planIndividualDeductibleout-of-networkemergencyroom visitcostnon-preferredbrand drugsout ofnetwork costIn-networkOutpatientMentalhealth carecostOut-of-networkout-of-pocket limitIn-networkUrgentCare visitcostfamilydeductibleCoveragePeriodin-networkdurablemedicalequipmentcostIn-networkpreventativecare/screeningcostcoinsuranceforanesthesiaemergencymedicaltransportationin-networkcostOut-of-pocketlimitexclusionsPrimarycare visitin-networkcostspecialistvisit in-networkcostspecialtydrugs in-networkcostIn-networkinpatientmentalhealth staycostHospitalstay in-networkcostpreferredbrand RXout-of-network costPlanTypeOut-of-networkdiagnosistest costGenericdrugs in-networkcostIn-networkout-of-Pocketlimitin-networkphysician/surgeonfeesIn-networkimagingcostspecialistvisit out-of-networkcostOut-of-networkskillednursing costdo yourequire areferral tosee aspecialist?hospitalstay out-of-networkcostnon-preferredbrand drugsin-networkcostservicesnotcoveredby planIndividualDeductibleout-of-networkemergencyroom visitcostnon-preferredbrand drugsout ofnetwork costIn-networkOutpatientMentalhealth carecostOut-of-networkout-of-pocket limitIn-networkUrgentCare visitcostfamilydeductibleCoveragePeriodin-networkdurablemedicalequipmentcostIn-networkpreventativecare/screeningcostcoinsuranceforanesthesiaemergencymedicaltransportationin-networkcostOut-of-pocketlimitexclusionsPrimarycare visitin-networkcostspecialistvisit in-networkcostspecialtydrugs in-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 inpatient mental health stay cost
  2. Hospital stay in-network cost
  3. preferred brand RX out-of-network cost
  4. Plan Type
  5. Out-of-network diagnosis test cost
  6. Generic drugs in-network cost
  7. In-network out-of-Pocket limit
  8. in-network physician/ surgeon fees
  9. In-network imaging cost
  10. specialist visit out-of-network cost
  11. Out-of-network skilled nursing cost
  12. do you require a referral to see a specialist?
  13. hospital stay out-of-network cost
  14. non-preferred brand drugs in-network cost
  15. services not covered by plan
  16. Individual Deductible
  17. out-of-network emergency room visit cost
  18. non-preferred brand drugs out of network cost
  19. In-network Outpatient Mental health care cost
  20. Out-of-network out-of-pocket limit
  21. In-network Urgent Care visit cost
  22. family deductible
  23. Coverage Period
  24. in-network durable medical equipment cost
  25. In-network preventative care/screening cost
  26. coinsurance for anesthesia
  27. emergency medical transportation in-network cost
  28. Out-of-pocket limit exclusions
  29. Primary care visit in-network cost
  30. specialist visit in-network cost
  31. specialty drugs in-network cost